Provider Demographics
NPI:1265130579
Name:MWAURA, GEORGE GACHERU
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:GACHERU
Last Name:MWAURA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29424 PACIFIC HWY S STE A
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-3800
Mailing Address - Country:US
Mailing Address - Phone:206-231-7628
Mailing Address - Fax:
Practice Address - Street 1:29424 PACIFIC HWY S STE A
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-3800
Practice Address - Country:US
Practice Address - Phone:206-231-7628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic