Provider Demographics
NPI:1073159828
Name:SEYOUM, TSEHAY M (RND)
Entity Type:Individual
Prefix:
First Name:TSEHAY
Middle Name:M
Last Name:SEYOUM
Suffix:
Gender:F
Credentials:RND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16432 40TH PL W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-9023
Mailing Address - Country:US
Mailing Address - Phone:206-919-8722
Mailing Address - Fax:425-357-1170
Practice Address - Street 1:16432 40TH PL W
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-9023
Practice Address - Country:US
Practice Address - Phone:206-919-8722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60276633163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse