Individual
LIA GEDAMU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3927 RUCKER AVE, EVERETT, WA 98201-4833
(425) 339-5421
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(206) 860-5414
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
95003319
CA
363L00000X
Nurse Practitioner
Primary
AP70054264
WA
Other
Enumeration date
06/03/2016
Last updated
01/12/2026
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