Individual
NGWEH AZAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CEO
Contact information
Practice address
707 S GRADY WAY STE 600, RENTON, WA 98057-3227
(702) 788-2378
Mailing address
22829 SE 239TH CT, MAPLE VALLEY, WA 98038-5052
(702) 788-2378
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
PRIVATE PAY
—
Enumeration date
09/22/2022
Last updated
09/22/2022
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