Healthcare Provider Details

I. General information

NPI: 1023947637
Provider Name (Legal Business Name): YOHANNES BAYE NAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31512 36TH AVE SW
FEDERAL WAY WA
98023-2104
US

IV. Provider business mailing address

31512 36TH AVE SW
FEDERAL WAY WA
98023-2104
US

V. Phone/Fax

Practice location:
  • Phone: 206-536-9202
  • Fax:
Mailing address:
  • Phone: 206-536-9202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNC61641220
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: