Absira Eshetu Tadesse, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN60622980 Issued in WA

Practice address

24737 14TH Ave S
Des Moines, WA 98198-7815

Phone

(206) 228-3360

Fax

(206) 400-7773

NPI assigned

Jan 26, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alpha1 Adult Family Home LLC

  • Adult Care Home Facility
  • Des Moines, WA
  • NPI 1174385991
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1063274876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24737 14TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987815",
            "telephone_number": "206-228-3360",
            "fax_number": "206-400-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24737 14TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987815",
            "telephone_number": "206-228-3360",
            "fax_number": "206-400-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADESSE",
        "first_name": "ABSIRA",
        "middle_name": "ESHETU",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60622980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Still Waters Therapeutic PLLC
• Kelly Stockdale-Nielsen, PT
• Nicole J Stumpf, LMP
• Anuta S Sulzhik
• Phavikone Sundara, ACUPUNCTURIST
• Allen Brian Tanner, DC
• Yenealem Tesfaye Tassew
• Shannon Tebbetts, RN
• Vu H Thach
• Purnima Thapa

• Registered Nurse in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.