Healthcare Provider Details

I. General information

NPI: 1811811805
Provider Name (Legal Business Name): KEDEST AYELE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2237 N 106TH ST APT 231
SEATTLE WA
98133-9576
US

IV. Provider business mailing address

2237 N 106TH ST APT 231
SEATTLE WA
98133-9576
US

V. Phone/Fax

Practice location:
  • Phone: 120-695-4464
  • Fax:
Mailing address:
  • Phone: 120-695-4464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number0001325852
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: