Provider Demographics
NPI:1013716810
Name:KONTEH, MARIAMA L
Entity type:Individual
Prefix:
First Name:MARIAMA
Middle Name:L
Last Name:KONTEH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18225 52ND AVE W APT B209
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4669
Mailing Address - Country:US
Mailing Address - Phone:425-543-3365
Mailing Address - Fax:
Practice Address - Street 1:11400 AIRPORT RD STE 200
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-8711
Practice Address - Country:US
Practice Address - Phone:425-543-3365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHM61168089374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide