Provider Demographics
NPI:1851168876
Name:MUGWE, PRISCILLA WANJIRU II
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:WANJIRU
Last Name:MUGWE
Suffix:II
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 1:32200 MILITARY RD S APT T206
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98001-5126
Mailing Address - Country:US
Mailing Address - Phone:253-754-7654
Mailing Address - Fax:
Practice Address - Street 1:32200 MILITARY RD S APT T206
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98001-5126
Practice Address - Country:US
Practice Address - Phone:253-754-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC61378550376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide