Provider Demographics
NPI:1770350639
Name:MWENYURA, SERAH NYAKIO
Entity type:Individual
Prefix:
First Name:SERAH
Middle Name:NYAKIO
Last Name:MWENYURA
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 1:2804 QUEENS WAY APT 3E
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WA
Mailing Address - Zip Code:98354-9014
Mailing Address - Country:US
Mailing Address - Phone:253-455-6925
Mailing Address - Fax:
Practice Address - Street 1:2804 QUEENS WAY APT 3E
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WA
Practice Address - Zip Code:98354-9014
Practice Address - Country:US
Practice Address - Phone:253-455-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61340172376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide