Provider Demographics
NPI:1467296582
Name:KELELEW, MERON K (RN61084045)
Entity type:Individual
Prefix:
First Name:MERON
Middle Name:K
Last Name:KELELEW
Suffix:
Gender:F
Credentials:RN61084045
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 S 107TH ST APT A2
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98168-1760
Mailing Address - Country:US
Mailing Address - Phone:206-596-5004
Mailing Address - Fax:
Practice Address - Street 1:2106 S 107TH ST APT A2
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98168-1760
Practice Address - Country:US
Practice Address - Phone:206-596-5004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61084045163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health