=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275432585
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMANUEL G TEKLEZGI NP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/03/2026
-----------------------------------------------------
Last Update Date | 11/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16444 32ND AVE S 16444 32ND AVE S
-----------------------------------------------------
City | SEATAC
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98188-3021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-351-0546
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16444 32ND AVE S 16444 32ND AVE S
-----------------------------------------------------
City | SEATAC
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98188-3021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-351-0546
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Registered Nurse
-----------------------------------------------------
License Number | AP70197525
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------