Provider Demographics
NPI:1366316895
Name:AREKO, ENDESHAW SHIFERAW
Entity type:Individual
Prefix:
First Name:ENDESHAW
Middle Name:SHIFERAW
Last Name:AREKO
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 1:8502 NE 166TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-2861
Mailing Address - Country:US
Mailing Address - Phone:503-863-8448
Mailing Address - Fax:
Practice Address - Street 1:6400 NE 164TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-3717
Practice Address - Country:US
Practice Address - Phone:503-863-8448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA753555374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide