Provider Demographics
NPI:1558527028
Name:KIFLE, SELAM
Entity Type:Individual
Prefix:MS
First Name:SELAM
Middle Name:
Last Name:KIFLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 22ND AVE S
Mailing Address - Street 2:STE. 103
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2259
Mailing Address - Country:US
Mailing Address - Phone:206-328-6251
Mailing Address - Fax:
Practice Address - Street 1:308 22ND AVE S
Practice Address - Street 2:STE. 103
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2259
Practice Address - Country:US
Practice Address - Phone:206-328-6251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602706626251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health