Individual
NELLY WANJIRU BAMASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9500 FRONT ST S STE 100, LAKEWOOD, WA 98499-9415
(253) 584-3996
(253) 589-1071
Mailing address
9500 FRONT ST S STE 100, LAKEWOOD, WA 98499-9415
(253) 584-3996
(253) 589-1071
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60720788
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP60720788
LPN
WA
Enumeration date
07/19/2018
Last updated
07/19/2018
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