Provider Demographics
NPI:1376153148
Name:GITHU, SOSPETER GITAU
Entity Type:Individual
Prefix:
First Name:SOSPETER
Middle Name:GITAU
Last Name:GITHU
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 1:2026 179TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-4123
Mailing Address - Country:US
Mailing Address - Phone:508-847-0714
Mailing Address - Fax:
Practice Address - Street 1:2026 179TH STREET CT E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-4123
Practice Address - Country:US
Practice Address - Phone:508-847-0714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-05
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61016140163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse