Provider Demographics
NPI:1538042494
Name:KINYANJUI, HUMPHREY M (LPN)
Entity type:Individual
Prefix:
First Name:HUMPHREY
Middle Name:M
Last Name:KINYANJUI
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 97TH ST S APT E14
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-6644
Mailing Address - Country:US
Mailing Address - Phone:816-462-5001
Mailing Address - Fax:
Practice Address - Street 1:1704 97TH ST S APT E14
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-6644
Practice Address - Country:US
Practice Address - Phone:816-462-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60464389164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse