Provider Demographics
NPI:1740050749
Name:GIKUNDA, JOHN KIMATHI
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:KIMATHI
Last Name:GIKUNDA
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 1:9210 S HOSMER ST APT E15
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-6876
Mailing Address - Country:US
Mailing Address - Phone:206-571-3881
Mailing Address - Fax:
Practice Address - Street 1:402 NJ ST TACOMA 98403
Practice Address - Street 2:HOUSE
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403
Practice Address - Country:US
Practice Address - Phone:206-214-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide