Individual provider Active NPI

Samson Peter Mvandal, RN, BSN, PDN, MPH

  • Registered Nurse
  • Kent, WA
National Provider Identifier
1972425437
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN61630184 Issued in WA
Practice address
12433 SE 275TH PL
Kent, WA 98030-8518
Phone
(360) 500-3652
NPI assigned
Jul 28, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN61630184 WA Primary

Addresses

Primary practice location

12433 SE 275TH PL
Kent, WA 98030-8518

Mailing address

32200 Military Rd S Apt N304
Federal Way, WA 98001-9659
Phone (360) 500-3652

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": "1785196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1972425437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32200 MILITARY RD S APT N304",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980019659",
            "telephone_number": "360-500-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12433 SE 275TH PL",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980308518",
            "telephone_number": "360-500-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MVANDAL",
        "first_name": "SAMSON",
        "middle_name": "PETER",
        "credential": "RN, BSN, PDN, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-28",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61630184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.