Provider Demographics
NPI:1518611417
Name:NGANGA, ELIZABETH WAMBUI (DO)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WAMBUI
Last Name:NGANGA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4957 LAKEMONT BLVD SE STE C4-103
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-7801
Mailing Address - Country:US
Mailing Address - Phone:913-963-0614
Mailing Address - Fax:
Practice Address - Street 1:4957 LAKEMONT BLVD SE # C4-103
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-7801
Practice Address - Country:US
Practice Address - Phone:913-963-0614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61093697163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice