Healthcare Provider Details

I. General information

NPI: 1639909112
Provider Name (Legal Business Name): OLUWAKEMI FLORENCE OLUWAYEMI CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 3RD AVE
SEATTLE WA
98104-2304
US

IV. Provider business mailing address

15320 33RD AVE S APT S610
SEATAC WA
98188-5190
US

V. Phone/Fax

Practice location:
  • Phone: 206-454-1570
  • Fax:
Mailing address:
  • Phone: 612-383-8086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number61184320
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number61184320
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: