Provider Demographics
NPI:1831950807
Name:KIBREAB, SENAIT TESFAHUNEY (HCA)
Entity type:Individual
Prefix:
First Name:SENAIT
Middle Name:TESFAHUNEY
Last Name:KIBREAB
Suffix:
Gender:F
Credentials:HCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18610 NE 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-6115
Mailing Address - Country:US
Mailing Address - Phone:408-470-9418
Mailing Address - Fax:
Practice Address - Street 1:18610 NE 109TH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-6115
Practice Address - Country:US
Practice Address - Phone:408-470-9418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA756812104100000X
756812104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker