Active NPI
Lily Seyoum
- Nurse Practitioner
- Tukwila, WA
National Provider Identifier
1174160030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP.61221290
- Practice address
- 12844 Military Rd S
Tukwila, WA 98168-3045 - Phone
- (206) 745-4473
- NPI assigned
- Dec 10, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | RN60664176 | WA | |
| Nurse Practitioner | 363L00000X | AP.61221290 | WA | Primary |
Addresses
Primary practice location
12844 Military Rd S
Tukwila, WA 98168-3045
Mailing address
15362 173Rd Ave SE
Monroe, WA 98272-2704
Phone (206) 981-0444
Other practice location 1
531 Queen Anne Ave N
Seattle, WA 98109-4521
Phone (206) 284-7286
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 |
|---|---|---|---|
| RN60664176 | WA | MD | Medical-Surgical Registered Nurse |
| AP.61221290 | WA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655769600000",
"number": "1174160030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15362 173RD AVE SE",
"city": "MONROE",
"state": "WA",
"postal_code": "982722704",
"telephone_number": "206-981-0444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12844 MILITARY RD S",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981683045",
"telephone_number": "206-745-4473"
}
],
"practiceLocations": [
{
"address_1": "531 Queen Anne Ave N",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981094521",
"country_code": "US",
"telephone_number": "206-284-7286",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEYOUM",
"first_name": "LILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-10",
"last_updated": "2022-06-21",
"certification_date": "2022-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "WA",
"license": "RN60664176",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP.61221290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tukwila, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.