Provider Demographics
NPI:1538757927
Name:MULUMBA, MUKISA NGOZI
Entity type:Individual
Prefix:
First Name:MUKISA
Middle Name:NGOZI
Last Name:MULUMBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12556 15TH AVE NE APT 105
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4039
Mailing Address - Country:US
Mailing Address - Phone:206-876-0714
Mailing Address - Fax:
Practice Address - Street 1:12556 15TH AVE NE APT 105
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4039
Practice Address - Country:US
Practice Address - Phone:206-876-0714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-01
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula