Provider Demographics
NPI:1083219323
Name:KARIUKI, MARY (LPN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:KARIUKI
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 1:8720 MADRONA LN
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8653
Mailing Address - Country:US
Mailing Address - Phone:425-260-9375
Mailing Address - Fax:
Practice Address - Street 1:8720 MADRONA LN
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8653
Practice Address - Country:US
Practice Address - Phone:425-260-9375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60188192164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse