Organization
ELLA BLLA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWIT T ASFAHA (OWNER)
(206) 632-2015
Entity
Organization
Contact information
Practice address
2330 189TH PL SW, LYNNWOOD, WA 98036-4875
(206) 632-2015
(425) 670-2037
Mailing address
4320 196TH ST SW # B736, LYNNWOOD, WA 98036-6773
(206) 632-2015
(425) 670-2037
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
603041592
LICENSE
—
Enumeration date
11/30/2018
Last updated
11/30/2018
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