Provider Demographics
NPI:1609492701
Name:NDIRITU, ROSE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:NDIRITU
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7217 91ST AVENUE CT SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-7100
Mailing Address - Country:US
Mailing Address - Phone:253-341-8755
Mailing Address - Fax:
Practice Address - Street 1:7217 91ST AVENUE CT SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-7100
Practice Address - Country:US
Practice Address - Phone:253-341-8755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60105094163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse