Provider Demographics
NPI:1235906058
Name:RAINEY, ESTHER KWAISOKA
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:KWAISOKA
Last Name:RAINEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:KWAISOKA
Other - Last Name:NZISI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18558 97TH AVE E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-6325
Mailing Address - Country:US
Mailing Address - Phone:141-749-6291
Mailing Address - Fax:
Practice Address - Street 1:18558 97TH AVE E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-6325
Practice Address - Country:US
Practice Address - Phone:141-749-6291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60678705164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse