Provider Demographics
NPI:1851857775
Name:MBATAI, SHEILAH MBURU (RND)
Entity Type:Individual
Prefix:
First Name:SHEILAH
Middle Name:MBURU
Last Name:MBATAI
Suffix:
Gender:F
Credentials:RND
Other - Prefix:
Other - First Name:SHEILAH
Other - Middle Name:WAMBUI
Other - Last Name:MBURU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7415 46TH AVE W
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-2504
Mailing Address - Country:US
Mailing Address - Phone:206-913-3944
Mailing Address - Fax:425-374-2027
Practice Address - Street 1:811 MADISON ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-4543
Practice Address - Country:US
Practice Address - Phone:425-212-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00150894163W00000X
WAAP61398281363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty