Provider Demographics
NPI:1124651245
Name:LUNA NURSE DELEGATION PLLC
Entity type:Organization
Organization Name:LUNA NURSE DELEGATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TSEHAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SEYOUM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:206-919-8722
Mailing Address - Street 1:16432 40TH PL W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-9023
Mailing Address - Country:US
Mailing Address - Phone:206-919-8722
Mailing Address - Fax:425-357-1170
Practice Address - Street 1:16432 40TH PL W
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-9023
Practice Address - Country:US
Practice Address - Phone:206-919-8722
Practice Address - Fax:425-357-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty