Provider Demographics
NPI:1386412278
Name:ALEMU, TIKDEM
Entity type:Individual
Prefix:
First Name:TIKDEM
Middle Name:
Last Name:ALEMU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11062 OCCIDENTAL AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98168-1404
Mailing Address - Country:US
Mailing Address - Phone:425-221-0147
Mailing Address - Fax:
Practice Address - Street 1:4699 OLD IRONSIDES DR STE 230
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-1858
Practice Address - Country:US
Practice Address - Phone:040-886-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60225710374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide