Provider Demographics
NPI:1184414005
Name:AKPOBOME, SAMSON (SOLE PROPRIETOR)
Entity type:Individual
Prefix:
First Name:SAMSON
Middle Name:
Last Name:AKPOBOME
Suffix:
Gender:M
Credentials:SOLE PROPRIETOR
Other - Prefix:DR
Other - First Name:SAMSON
Other - Middle Name:
Other - Last Name:AKPOBOME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:30305 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4014
Mailing Address - Country:US
Mailing Address - Phone:425-306-6497
Mailing Address - Fax:
Practice Address - Street 1:30305 6TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4014
Practice Address - Country:US
Practice Address - Phone:425-306-6497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide