Individual
JEAN CLEMENT NIKUBWAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
3510 STEELHAMMER DR, CENTRALIA, WA 98531-1532
(360) 623-8020
(360) 623-1072
Mailing address
2428 W REYNOLDS AVE, CENTRALIA, WA 98531-4554
(360) 330-9044
(360) 736-0689
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61576057
WA
Other
Enumeration date
09/16/2024
Last updated
10/01/2024
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