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General NPI Number Information
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NPI Number | 1689523094
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Entity Type | Organization
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Legal Business Name | WUDIYE LLC
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 5502 OCEAN AVE
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City | EVERETT
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State | WA
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Zip | 98203-1309
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Country | US
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Telephone | 425-595-6950
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Fax | 425-595-6737
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Provider Business Mailing Address
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Address Line | 5502 OCEAN AVE
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City | EVERETT
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State | WA
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Zip | 98203-1309
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Country | US
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Telephone | 425-595-6950
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Fax | 425-595-6737
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Authorized Official
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Title or Position | PROVIDER/EMPLOYEE
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Name | TEDLA MENGESHA WOLDEMARIAM
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Credential |
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Telephone | 206-850-9539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number |
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License Number State |
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