Provider Demographics
NPI:1265276604
Name:TESHOME, BETELIHEM
Entity type:Individual
Prefix:
First Name:BETELIHEM
Middle Name:
Last Name:TESHOME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32326 48TH AVE S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-2633
Mailing Address - Country:US
Mailing Address - Phone:206-334-7018
Mailing Address - Fax:
Practice Address - Street 1:32326 48TH AVE S
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-2633
Practice Address - Country:US
Practice Address - Phone:206-334-7018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60479319163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health