Provider Demographics
NPI:1043857485
Name:NJOROGE, SERAH WANJIRU (LPN)
Entity Type:Individual
Prefix:
First Name:SERAH
Middle Name:WANJIRU
Last Name:NJOROGE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 NE 129TH PL # 1
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-2215
Mailing Address - Country:US
Mailing Address - Phone:206-913-3036
Mailing Address - Fax:
Practice Address - Street 1:14109 SE 282ND ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-3916
Practice Address - Country:US
Practice Address - Phone:971-279-5130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00053265164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse