MEDICARE: PRINCIPE NDONDO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747A0650X	Attendant Care Provider	NAR.NA.70015256	WA
2	3747P1801X	Personal Care Attendant	NAR.NA.70015256	WA
3	374U00000X	Home Health Aide	HMCC.HM.70027488	WA

General Provider Information

NPI Number	:	1548137615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRINCIPE NDONDO

Provider Business Mailing Address
First Line	:	8830 NESBIT AVE N APT 6
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4086
Country	:	US
Telephone Number	:	253-534-5790
Fax Number	:

Provider Business Practice Location Address
First Line	:	8830 NESBIT AVE N APT 6
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4086
Country	:	US
Telephone Number	:	253-534-5790
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2025
Last Update Date	:	10/22/2025

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Directions to “ PRINCIPE NDONDO ” Practice Location

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