Provider Demographics
NPI:1598336307
Name:MEKONNEN, ZEWDU M
Entity Type:Individual
Prefix:
First Name:ZEWDU
Middle Name:M
Last Name:MEKONNEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13033 OCCIDENTAL AVE S
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98168-2628
Mailing Address - Country:US
Mailing Address - Phone:206-939-3930
Mailing Address - Fax:
Practice Address - Street 1:13033 OCCIDENTAL AVE S
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98168-2628
Practice Address - Country:US
Practice Address - Phone:206-939-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-03
Last Update Date:2021-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter