Provider Demographics
NPI:1326462664
Name:DEMISSIE, GETACHEW ZEWDIE
Entity type:Individual
Prefix:MR
First Name:GETACHEW
Middle Name:ZEWDIE
Last Name:DEMISSIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12833 14TH AVE W
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-7577
Mailing Address - Country:US
Mailing Address - Phone:206-602-9097
Mailing Address - Fax:
Practice Address - Street 1:12833 14TH AVE W
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-7577
Practice Address - Country:US
Practice Address - Phone:206-602-9097
Practice Address - Fax:206-542-6931
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00162316163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse