Healthcare Provider Details

I. General information

NPI: 1457011363
Provider Name (Legal Business Name): LADAN HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2021
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13922 SE 275TH ST
KENT WA
98042-9029
US

IV. Provider business mailing address

13922 SE 275TH ST
KENT WA
98042-9029
US

V. Phone/Fax

Practice location:
  • Phone: 206-819-4342
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FADUMO ADEN
Title or Position: CEO
Credential:
Phone: 206-819-4342