Healthcare Provider Details

I. General information

NPI: 1417826835
Provider Name (Legal Business Name): CESEN HAILESELLASSIE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 37TH AVE S
SEATTLE WA
98118-1609
US

IV. Provider business mailing address

4400 37TH AVE S
SEATTLE WA
98118-1609
US

V. Phone/Fax

Practice location:
  • Phone: 206-296-4650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: