Provider Demographics
NPI:1437814183
Name:WANJIRU, CECILIAH
Entity Type:Individual
Prefix:
First Name:CECILIAH
Middle Name:
Last Name:WANJIRU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16045 SE 170TH CT
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-8654
Mailing Address - Country:US
Mailing Address - Phone:402-619-8232
Mailing Address - Fax:
Practice Address - Street 1:16045 SE 170TH CT
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-8654
Practice Address - Country:US
Practice Address - Phone:402-619-8232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-07
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60952517163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical