Provider Demographics
NPI:1225626849
Name:KARIUKI, EVARLYN NYANCHAMA
Entity Type:Individual
Prefix:
First Name:EVARLYN
Middle Name:NYANCHAMA
Last Name:KARIUKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EVARLYN
Other - Middle Name:NYANCHAMA
Other - Last Name:ONYAMBU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17501 OAK ST
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:98252-8998
Mailing Address - Country:US
Mailing Address - Phone:425-280-9297
Mailing Address - Fax:
Practice Address - Street 1:17501 OAK ST
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:WA
Practice Address - Zip Code:98252-8998
Practice Address - Country:US
Practice Address - Phone:425-280-9297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG61023093101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health