Provider Demographics
NPI:1477253128
Name:KARIUKI, LYDIAH WANGARI
Entity type:Individual
Prefix:
First Name:LYDIAH
Middle Name:WANGARI
Last Name:KARIUKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 SW 317TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2202
Mailing Address - Country:US
Mailing Address - Phone:206-293-3798
Mailing Address - Fax:253-276-6483
Practice Address - Street 1:2402 SW 317TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2202
Practice Address - Country:US
Practice Address - Phone:206-293-3798
Practice Address - Fax:253-276-6483
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA755750374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA872655763Medicaid