Provider Demographics
NPI:1396617387
Name:ADUGNA, TSEGEREDA KASSIE
Entity type:Individual
Prefix:
First Name:TSEGEREDA
Middle Name:KASSIE
Last Name:ADUGNA
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 1:31408 28TH PL SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-7837
Mailing Address - Country:US
Mailing Address - Phone:206-335-7736
Mailing Address - Fax:253-235-5787
Practice Address - Street 1:31408 28TH PL SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-7837
Practice Address - Country:US
Practice Address - Phone:206-335-7736
Practice Address - Fax:253-235-5787
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN602363363747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider