Provider Demographics
NPI:1255219648
Name:SMITH, SYLVIA NAMWERUKA
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:NAMWERUKA
Last Name:SMITH
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 1:17946 50TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-4609
Mailing Address - Country:US
Mailing Address - Phone:253-365-7117
Mailing Address - Fax:
Practice Address - Street 1:17946 50TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-4609
Practice Address - Country:US
Practice Address - Phone:253-365-7117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA758018251E00000X, 311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No251E00000XAgenciesHome Health