Provider Demographics
NPI:1821269655
Name:IGBEKOYI, MARGARET KOKUMO
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:KOKUMO
Last Name:IGBEKOYI
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 1:805 S 309TH PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4736
Mailing Address - Country:US
Mailing Address - Phone:253-941-3293
Mailing Address - Fax:253-941-3293
Practice Address - Street 1:805 S 309TH PL
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4736
Practice Address - Country:US
Practice Address - Phone:253-941-3293
Practice Address - Fax:253-941-3293
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA750596311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home