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NPI Code Detail

MEDICARE: LIYA W TSEGAYE PH

MEDICARE: LIYA W TSEGAYE PH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist61059281WA

General Provider Information

NPI Number : 1598370637
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIYA W TSEGAYE PH
Provider Business Mailing Address
First Line : 912 N 96TH ST APT 226
Second Line :
City : SEATTLE
State : WA
Zip : 98103-3273
Country : US
Telephone Number : 206-446-5636
Fax Number :
Provider Business Practice Location Address
First Line : 4412 RAINIER AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98118-1373
Country : US
Telephone Number : 206-760-7880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2020
Last Update Date : 09/15/2020

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Directions to “ LIYA W TSEGAYE PH” Practice Location

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