Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP61099151 | WA |
NPI | 1073135661 |
---|---|
Provider Name | Azeb Zeleke |
First Address | Kent, WA 98032-1316 |
Second Address | Seattle, WA 98118-3510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2020 |
Last Update Date | 02/10/2020 |