Healthcare Provider Details

I. General information

NPI: 1346162948
Provider Name (Legal Business Name): GHIRMAI TESFAI TSEGAI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 33237
SEATTLE WA
98133-0237
US

IV. Provider business mailing address

PO BOX 33237
SEATTLE WA
98133-0237
US

V. Phone/Fax

Practice location:
  • Phone: 206-676-2516
  • Fax: 253-301-1762
Mailing address:
  • Phone: 206-676-2516
  • Fax: 253-301-1762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number603619758
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: