# VA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467621748
- **Authorized official:** MRS. SENAIT GEBRU WOLEMIHAEL (LPN)
- **Authorized official phone:** (206) 764-2087

## Contact information

- **Practice address:** 17928 33RD PL W, LYNNWOOD, WA 98037-7734
- **Practice address phone:** (425) 678-8557
- **Mailing address:** 17928 33RD PL W, LYNNWOOD, WA 98037-7734
- **Mailing address phone:** (425) 678-8557

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | LP00051995 | WA | Yes |

## Other

- **Enumeration date:** 02/21/2008
- **Last updated:** 02/21/2008