Individual
DEREJE G LULU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NAC,
Contact information
Practice address
14100 LINDEN AVE N, # 418, SEATTLE, WA 98133-7154
(206) 414-4710
(206) 494-7848
Mailing address
14100 LINDEN AVE N, # 418, SEATTLE, WA 98133-7154
(206) 549-9648
(206) 494-7848
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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