Provider Demographics
NPI:1700348042
Name:GELETO, BEREDU ABRAHAM (NP-C)
Entity Type:Individual
Prefix:MS
First Name:BEREDU
Middle Name:ABRAHAM
Last Name:GELETO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 BOREN AVE STE 1900
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3508
Mailing Address - Country:US
Mailing Address - Phone:206-622-6444
Mailing Address - Fax:
Practice Address - Street 1:901 BOREN AVE STE 1900
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3508
Practice Address - Country:US
Practice Address - Phone:206-622-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60476417163WM0705X, 363LS0200X
OR201806827RN163WM0705X
WAAP61134760363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool