Provider Demographics
NPI:1689194862
Name:TESFAY, SEBLE EMBAY (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:SEBLE
Middle Name:EMBAY
Last Name:TESFAY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6529 141ST ST SW
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-3515
Mailing Address - Country:US
Mailing Address - Phone:206-817-9010
Mailing Address - Fax:
Practice Address - Street 1:6529 141ST ST SW
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-3515
Practice Address - Country:US
Practice Address - Phone:206-817-9010
Practice Address - Fax:206-817-9010
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00158558163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse