Provider Demographics
NPI:1689310302
Name:BERHANE, GHRMAWIT T (CNA)
Entity Type:Individual
Prefix:
First Name:GHRMAWIT
Middle Name:T
Last Name:BERHANE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21823 92ND AVE W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-3972
Mailing Address - Country:US
Mailing Address - Phone:206-307-8395
Mailing Address - Fax:
Practice Address - Street 1:21823 92ND AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3972
Practice Address - Country:US
Practice Address - Phone:206-307-8395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider