Individual
MISS SALOME KHASUNGU SHIVACHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
208 TACOMA BLVD N, PACIFIC, WA 98047-1010
(205) 356-5838
Mailing address
208 TACOMA BLVD N, PACIFIC, WA 98047-1010
(205) 356-5838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60618577
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H2014
—
WA
Enumeration date
03/20/2018
Last updated
03/20/2018
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