Provider Demographics
NPI:1326605239
Name:NGUGI, MICHAEL CHEGE (NP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CHEGE
Last Name:NGUGI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SW 150TH ST
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1855
Mailing Address - Country:US
Mailing Address - Phone:314-374-9713
Mailing Address - Fax:
Practice Address - Street 1:801 SW 150TH ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1855
Practice Address - Country:US
Practice Address - Phone:314-374-9713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-26
Last Update Date:2019-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019012512363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner