Provider Demographics
NPI:1154652758
Name:KIHURIA, JOHN (RN)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:KIHURIA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11721 SE 264TH ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-8468
Mailing Address - Country:US
Mailing Address - Phone:253-277-2860
Mailing Address - Fax:
Practice Address - Street 1:11721 SE 264TH STREET
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030
Practice Address - Country:US
Practice Address - Phone:253-277-2860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2022-06-21
Deactivation Date:2011-01-11
Deactivation Code:
Reactivation Date:2022-06-21
Provider Licenses
StateLicense IDTaxonomies
WARN00166715163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse