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Individual

DR. TEWODROS DESIE GIZATU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
321 116TH ST S, TACOMA, WA 98444-5405
(253) 537-3022
Mailing address
321 116TH ST S, TACOMA, WA 98444-5405
(253) 537-3022

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60732624
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61266932
WA

Other

Enumeration date
03/11/2022
Last updated
03/11/2022
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