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Individual
DEREJE G LULU
Active
Individual
DEREJE G LULU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NAC,
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
IHS.FS.60405684
WA
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IHS.FS.60405684
WASHINGTON STATE HOME CARE AGENCE LICENSES PERMITSAND CERTIFICATES
WA
Enumeration date
03/28/2013
Last updated
02/12/2015
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