Provider Demographics
NPI:1942176649
Name:GULMA, BEZAWIT A
Entity type:Individual
Prefix:
First Name:BEZAWIT
Middle Name:A
Last Name:GULMA
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 1:650 146TH AVE NE APT H54
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-4790
Mailing Address - Country:US
Mailing Address - Phone:206-753-7940
Mailing Address - Fax:
Practice Address - Street 1:1515 116TH AVE NE STE 109
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3827
Practice Address - Country:US
Practice Address - Phone:425-283-5871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-11
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist