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Individual

HAILU MOLLA BANKASHE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
15130 STONE LN N APT D201, SHORELINE, WA 98133-2923
(206) 637-9301
Mailing address
15130 STONE LN N APT D201, SHORELINE, WA 98133-2923
(206) 637-9301

Taxonomy

Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
4471
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4471
DSHS
WA
Enumeration date
11/18/2020
Last updated
11/18/2020
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