Healthcare Provider Details

I. General information

NPI: 1164353884
Provider Name (Legal Business Name): ABNET DERAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 RAINIER AVE S STE 210
SEATTLE WA
98118-2445
US

IV. Provider business mailing address

5600 RAINIER AVE S STE 210
SEATTLE WA
98118-2445
US

V. Phone/Fax

Practice location:
  • Phone: 206-383-6111
  • Fax: 206-260-2741
Mailing address:
  • Phone: 206-383-6111
  • Fax: 206-260-2741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN.RN.61687147.MSL
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: