Provider Demographics
NPI:1912505785
Name:ADAL, TSEGEREDA THRUNH (RN)
Entity type:Individual
Prefix:
First Name:TSEGEREDA
Middle Name:THRUNH
Last Name:ADAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14800 46TH AVE S
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-4442
Mailing Address - Country:US
Mailing Address - Phone:206-353-3519
Mailing Address - Fax:206-258-3425
Practice Address - Street 1:14800 46TH AVE S
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-4442
Practice Address - Country:US
Practice Address - Phone:206-353-3519
Practice Address - Fax:206-258-3425
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00151144163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health