Provider Demographics
NPI:1386341253
Name:ADEME, SIFRASH
Entity type:Individual
Prefix:
First Name:SIFRASH
Middle Name:
Last Name:ADEME
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11810 26TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98146-2403
Mailing Address - Country:US
Mailing Address - Phone:206-788-6229
Mailing Address - Fax:
Practice Address - Street 1:11810 26TH AVE SW
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98146-2403
Practice Address - Country:US
Practice Address - Phone:206-788-6229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60152399163W00000X
WAAP61678562363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse