Provider Demographics
NPI:1376316943
Name:LIVING EXPRESSION PLLC
Entity Type:Organization
Organization Name:LIVING EXPRESSION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:NGINYI-MUNYOLI
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:832-605-6907
Mailing Address - Street 1:720 N 10TH ST STE A420
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5683
Mailing Address - Country:US
Mailing Address - Phone:832-605-6907
Mailing Address - Fax:
Practice Address - Street 1:11821 82ND PL S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-5180
Practice Address - Country:US
Practice Address - Phone:832-605-6907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty