Provider Demographics
NPI:1942777453
Name:SAMMY GATHIRU ARNP
Entity Type:Organization
Organization Name:SAMMY GATHIRU ARNP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GATHIRU
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:253-983-8507
Mailing Address - Street 1:3921 62ND AVE E
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-2377
Mailing Address - Country:US
Mailing Address - Phone:253-983-8507
Mailing Address - Fax:
Practice Address - Street 1:6212 75TH ST W
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8368
Practice Address - Country:US
Practice Address - Phone:253-983-8507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty