Provider Demographics
NPI:1871467639
Name:LIBNEH, HIRUT A
Entity type:Individual
Prefix:
First Name:HIRUT
Middle Name:A
Last Name:LIBNEH
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15414 35TH AVE W UNIT 27
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-5031
Mailing Address - Country:US
Mailing Address - Phone:425-984-9070
Mailing Address - Fax:
Practice Address - Street 1:15414 35TH AVE W UNIT 27
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-5031
Practice Address - Country:US
Practice Address - Phone:425-984-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61324882163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse