Provider Demographics
NPI:1790580629
Name:NGUNYI, NELSON KAHORO
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:KAHORO
Last Name:NGUNYI
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 1:1439 SW 204TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97003-2066
Mailing Address - Country:US
Mailing Address - Phone:214-714-2350
Mailing Address - Fax:
Practice Address - Street 1:1439 SW 204TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97003-2066
Practice Address - Country:US
Practice Address - Phone:214-714-2350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10026831163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health