Individual provider Active NPI

Yetnayet Kebede Gebredingle

  • Adult Care Home Facility
  • Vancouver, WA
National Provider Identifier
1487591905
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
758887 Issued in WA
Practice address
501 SE 171St Ave
Vancouver, WA 98684-8414
Phone
(304) 685-7759
NPI assigned
May 1, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 758887 WA Primary

Addresses

Primary practice location

501 SE 171St Ave
Vancouver, WA 98684-8414

Mailing address

501 SE 171St Ave
Vancouver, WA 98684-8414
Phone (304) 685-7759

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

LicenseStateTypeSpecialty
758887WAMDAdult Care Home Facility

NPI Registry JSON

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

{
    "created_epoch": "1777593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1487591905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SE 171ST AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986848414",
            "telephone_number": "304-685-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE 171ST AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986848414",
            "telephone_number": "304-685-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREDINGLE",
        "first_name": "YETNAYET",
        "middle_name": "KEBEDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-01",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WA",
            "license": "758887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.