Provider Demographics
NPI:1356634398
Name:BEYENE, ALEMBANCHI ABERA (LMP)
Entity Type:Individual
Prefix:MRS
First Name:ALEMBANCHI
Middle Name:ABERA
Last Name:BEYENE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 S. 174TH ST.
Mailing Address - Street 2:B-205
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1760
Mailing Address - Country:US
Mailing Address - Phone:206-551-6941
Mailing Address - Fax:
Practice Address - Street 1:2366 EASTLAKE AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3366
Practice Address - Country:US
Practice Address - Phone:206-497-8424
Practice Address - Fax:206-400-2787
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60187919225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist