Provider Demographics
NPI:1073143160
Name:MWANGI, DORCAS (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:DORCAS
Middle Name:
Last Name:MWANGI
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 SOUTHCENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2547
Mailing Address - Country:US
Mailing Address - Phone:206-901-2041
Mailing Address - Fax:
Practice Address - Street 1:4200 STONE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7431
Practice Address - Country:US
Practice Address - Phone:206-461-3707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-17
Last Update Date:2022-07-11
Deactivation Date:2022-05-18
Deactivation Code:
Reactivation Date:2022-07-11
Provider Licenses
StateLicense IDTaxonomies
WAAP61083547363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health