Healthcare Provider Details

I. General information

NPI: 1700794195
Provider Name (Legal Business Name): TIMELES MANAYE ASEGU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29721 52ND AVE S
AUBURN WA
98001-2344
US

IV. Provider business mailing address

29721 52ND AVE S
AUBURN WA
98001-2344
US

V. Phone/Fax

Practice location:
  • Phone: 206-432-6765
  • Fax: 253-409-2650
Mailing address:
  • Phone: 206-432-6765
  • Fax: 253-409-2650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number757860
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: