Provider Demographics
NPI:1992505499
Name:ANGLE CARE KENMORE AFH
Entity type:Organization
Organization Name:ANGLE CARE KENMORE AFH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:WEYNI
Authorized Official - Middle Name:BERHE
Authorized Official - Last Name:GHEBREYOUHANNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-830-7168
Mailing Address - Street 1:18504 61ST PL NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-3202
Mailing Address - Country:US
Mailing Address - Phone:360-830-7168
Mailing Address - Fax:425-949-5064
Practice Address - Street 1:18504 61ST PL NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-3202
Practice Address - Country:US
Practice Address - Phone:360-830-7168
Practice Address - Fax:425-949-5064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-14
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty