Provider Demographics
NPI:1134004716
Name:MUKIMA, MARY MURUGI (RN)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:MURUGI
Last Name:MUKIMA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7133 N LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-3205
Mailing Address - Country:US
Mailing Address - Phone:206-406-4848
Mailing Address - Fax:
Practice Address - Street 1:5622 SE MEYERS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97267-6653
Practice Address - Country:US
Practice Address - Phone:971-346-6314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10018005RN163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health