Individual provider Active NPI

Gary Mwangi Wahome

  • Nurse's Aide
  • Issaquah, WA
National Provider Identifier
1861260200
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
Practice address
3725 Providence Point Dr SE
Issaquah, WA 98029-7219
Phone
(425) 391-2800
NPI assigned
Dec 14, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X WA Primary

Addresses

Primary practice location

3725 Providence Point Dr SE
Issaquah, WA 98029-7219

Mailing address

PO Box 1904
Auburn, WA 98071-1904
Phone (206) 775-0819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1861260200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1904",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980711904",
            "telephone_number": "206-775-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 PROVIDENCE POINT DR SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980297219",
            "telephone_number": "425-391-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHOME",
        "first_name": "GARY",
        "middle_name": "MWANGI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-14",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.