Provider Demographics
NPI:1831969195
Name:NGARE, LUCY W
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:W
Last Name:NGARE
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 1:32750 32ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2730
Mailing Address - Country:US
Mailing Address - Phone:206-653-4698
Mailing Address - Fax:888-813-0332
Practice Address - Street 1:32750 32ND AVE SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2730
Practice Address - Country:US
Practice Address - Phone:206-653-4698
Practice Address - Fax:888-813-0332
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7561083747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA47-3114658Medicaid