Provider Demographics
NPI:1184235418
Name:SSEMAKULA, AFUTHAL NDUGWA (BSN, RN)
Entity type:Individual
Prefix:
First Name:AFUTHAL
Middle Name:NDUGWA
Last Name:SSEMAKULA
Suffix:
Gender:M
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3122 49TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-2915
Mailing Address - Country:US
Mailing Address - Phone:253-301-9264
Mailing Address - Fax:
Practice Address - Street 1:614 RIVERSIDE DR APT B103
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6154
Practice Address - Country:US
Practice Address - Phone:253-301-9264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61073206163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health