=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376429720
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAYA PSYCHIATRY HEALTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2025
-----------------------------------------------------
Last Update Date | 11/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1455 NW LEARY WAY
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98107-5124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-819-0287
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2802 S 353RD PL
-----------------------------------------------------
City | FEDERAL WAY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98003-7221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-819-0287
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ABEBE BELETE
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 206-819-0287
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------