Provider Demographics
NPI:1225526114
Name:TESFAI, YORDANOS TSEHAYE (RN)
Entity Type:Individual
Prefix:
First Name:YORDANOS
Middle Name:TSEHAYE
Last Name:TESFAI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 164TH ST SW APT L105
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-8630
Mailing Address - Country:US
Mailing Address - Phone:214-603-2783
Mailing Address - Fax:
Practice Address - Street 1:4525 164TH ST SW APT L105
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-8630
Practice Address - Country:US
Practice Address - Phone:214-603-2783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60787171163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse