Provider Demographics
NPI:1194275123
Name:AHLBECK, SOMI ROSE (RN)
Entity type:Individual
Prefix:
First Name:SOMI
Middle Name:ROSE
Last Name:AHLBECK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SO-MI
Other - Middle Name:
Other - Last Name:YIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3832 S 253RD PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5602
Mailing Address - Country:US
Mailing Address - Phone:253-334-4695
Mailing Address - Fax:
Practice Address - Street 1:33505 13TH PL S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6337
Practice Address - Country:US
Practice Address - Phone:253-334-4695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60573810163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse