Healthcare Provider Details

I. General information

NPI: 1255172730
Provider Name (Legal Business Name): DEBORAH TESFAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 DELRIDGE WAY SW
SEATTLE WA
98106-1379
US

IV. Provider business mailing address

4555 DELRIDGE WAY SW
SEATTLE WA
98106-1379
US

V. Phone/Fax

Practice location:
  • Phone: 206-937-7680
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: