Active NPI
Meharu Mathewos Menedo
- Home Health Agency
- Everett, WA
National Provider Identifier
1093608564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 758058
- Practice address
- 2628 130TH St SE
Everett, WA 98208-7136 - Phone
- (206) 775-2063
- Fax
- (425) 332-3501
- NPI assigned
- Jun 2, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 758058 | WA | Primary |
Addresses
Primary practice location
2628 130TH St SE
Everett, WA 98208-7136
Mailing address
2628 130TH St SE
Everett, WA 98208-7136
Phone (206) 775-2063
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 758058 | WA | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748822400000",
"number": "1093608564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2628 130TH ST SE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982087136",
"telephone_number": "206-775-2063",
"fax_number": "425-332-3501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2628 130TH ST SE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982087136",
"telephone_number": "206-775-2063",
"fax_number": "425-332-3501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENEDO",
"first_name": "MEHARU",
"middle_name": "MATHEWOS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-06-02",
"last_updated": "2025-06-02",
"certification_date": "2025-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "WA",
"license": "758058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.