Provider Demographics
NPI:1083195689
Name:NJENGA, RUTH WANJIRU (MA60589837)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:WANJIRU
Last Name:NJENGA
Suffix:
Gender:F
Credentials:MA60589837
Other - Prefix:MS
Other - First Name:RUTH
Other - Middle Name:WANJIRU
Other - Last Name:NJENGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA60589837
Mailing Address - Street 1:19641 SE 259TH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-5045
Mailing Address - Country:US
Mailing Address - Phone:253-397-8602
Mailing Address - Fax:
Practice Address - Street 1:19641 SE 259TH ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-5045
Practice Address - Country:US
Practice Address - Phone:253-397-8602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60589837225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist