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Individual

BONTU GUDETA KENTIBA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
X
Credential
ARNP

Contact information

Practice address
605 WOODLAND SQUARE LOOP SE, LACEY, WA 98503-1045
(360) 764-8000
Mailing address
4410 GALLAGHER WAY NW, OLYMPIA, WA 98502-9005

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP70057059
WA

Other

Enumeration date
06/21/2024
Last updated
10/19/2025
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