Provider Demographics
NPI:1942077490
Name:MUTHII, PAULINE WANGU
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:WANGU
Last Name:MUTHII
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 1:5116 88TH STREET COURT SW
Mailing Address - Street 2:APTB304
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3137
Mailing Address - Country:US
Mailing Address - Phone:425-532-9181
Mailing Address - Fax:
Practice Address - Street 1:5116 88TH STREET COURT SW
Practice Address - Street 2:APTB304
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3137
Practice Address - Country:US
Practice Address - Phone:425-532-9181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61296645376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide