Provider Demographics
NPI:1245969310
Name:CHEFO, MEZGEBU MARKOS (RN)
Entity type:Individual
Prefix:
First Name:MEZGEBU
Middle Name:MARKOS
Last Name:CHEFO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10918 140TH ST E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-3300
Mailing Address - Country:US
Mailing Address - Phone:206-446-7492
Mailing Address - Fax:253-445-2955
Practice Address - Street 1:10918 140TH ST E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-3300
Practice Address - Country:US
Practice Address - Phone:206-446-7492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60500054163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse