Active NPI
Samson Peter Mvandal, RN, BSN, PDN, MPH
- Registered Nurse
- Kent, WA
National Provider Identifier
1972425437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN61630184
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.