Basic Information
Provider Information
NPI: 1265831911
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NGINYI MUNYOLI
FirstName: RACHEL
MiddleName: W.
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3600 LIND AVE SW
Address2: SUITE 100 ATTN CREDENTIALING
City: RENTON
State: WA
PostalCode: 980574970
CountryCode: US
TelephoneNumber: 4256902715
FaxNumber:  
Practice Location
Address1: 400 S 43RD ST
Address2:  
City: RENTON
State: WA
PostalCode: 980555714
CountryCode: US
TelephoneNumber: 4256565566
FaxNumber: 4256565567
Other Information
ProviderEnumerationDate: 08/19/2014
LastUpdateDate: 10/30/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WG0600XRN60993233WAN Nursing Service ProvidersRegistered NurseGerontology
363L00000X719800TXN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363L00000XAP60993229WAN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LG0600XAP60993229WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology

No ID Information.


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