Provider Demographics
NPI:1104625995
Name:HABTE, WOSENE HAILAMARIAM I (RN)
Entity type:Individual
Prefix:MRS
First Name:WOSENE
Middle Name:HAILAMARIAM
Last Name:HABTE
Suffix:I
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 79TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-8989
Mailing Address - Country:US
Mailing Address - Phone:425-240-2789
Mailing Address - Fax:
Practice Address - Street 1:5709 79TH AVE NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-8989
Practice Address - Country:US
Practice Address - Phone:425-240-2789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61117471163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse