Provider Demographics
NPI:1174193726
Name:NGANGA, STEPHEN MUCHUNGA
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MUCHUNGA
Last Name:NGANGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 S 320TH ST APT K6
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4613
Mailing Address - Country:US
Mailing Address - Phone:206-458-0995
Mailing Address - Fax:
Practice Address - Street 1:333 S 320TH ST APT K6
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4613
Practice Address - Country:US
Practice Address - Phone:206-458-0995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-27
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals