Individual
NABATANZI AGNES BEWAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
402 S 333RD ST STE 105, FEDERAL WAY, WA 98003-7099
(971) 251-5788
Mailing address
PO BOX 58608, RENTON, WA 98058-1608
(404) 558-3404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
047964
GA
207Q00000X
Family Medicine Physician
Primary
MD60752475
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2080457
—
WA
Enumeration date
10/25/2006
Last updated
12/02/2020
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