Provider Demographics
NPI:1457186835
Name:MBERWA, HUSSEIN MAINGWA (ARNP)
Entity type:Individual
Prefix:
First Name:HUSSEIN
Middle Name:MAINGWA
Last Name:MBERWA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32429 50TH CT SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-1918
Mailing Address - Country:US
Mailing Address - Phone:315-418-5535
Mailing Address - Fax:
Practice Address - Street 1:32429 50TH CT SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-1918
Practice Address - Country:US
Practice Address - Phone:315-418-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61603769363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health