Provider Demographics
NPI:1407672207
Name:ANDOM, NEGISTI T
Entity type:Individual
Prefix:
First Name:NEGISTI
Middle Name:T
Last Name:ANDOM
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 1:1438 S 120TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98168-1274
Mailing Address - Country:US
Mailing Address - Phone:443-220-4243
Mailing Address - Fax:
Practice Address - Street 1:15203 8TH AVE S
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148-1114
Practice Address - Country:US
Practice Address - Phone:206-679-0782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula