Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1124796321 |
---|---|
Provider Name | Reem Berihu Teclebrhan |
First Address | Seattle, WA 98106-2371 |
Second Address | Seattle, WA 98106-2371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2021 |
Last Update Date | 01/09/2021 |