Provider Demographics
NPI:1972274058
Name:AGUFA, ALLAN MUSUNGU (RN)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:MUSUNGU
Last Name:AGUFA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14324 55TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-9356
Mailing Address - Country:US
Mailing Address - Phone:469-363-1999
Mailing Address - Fax:
Practice Address - Street 1:14324 55TH AVE SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-9356
Practice Address - Country:US
Practice Address - Phone:469-363-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61113909163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse