Provider Demographics
NPI:1336830439
Name:GEBREWOLD, HELEN EYOB
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:EYOB
Last Name:GEBREWOLD
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 1:11709 37TH DR SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-5302
Mailing Address - Country:US
Mailing Address - Phone:425-338-2099
Mailing Address - Fax:425-948-7034
Practice Address - Street 1:11709 37TH DR SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-5302
Practice Address - Country:US
Practice Address - Phone:425-338-2099
Practice Address - Fax:425-948-7034
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10092058376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide