Tigist Emiru Seyoum, AG ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP61298660 Issued in WA

Practice address

834 SW 361St St
Federal Way, WA 98023-7290

Phone

(206) 859-7903

NPI assigned

May 13, 2022

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

Other identifiers 1

Other names 1

• Mrs. Tigist Emiru Seyoum Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1558008391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 SW 361ST ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980237290",
            "telephone_number": "206-859-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 SW 361ST ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980237290",
            "telephone_number": "206-859-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYOUM",
        "first_name": "TIGIST",
        "middle_name": "EMIRU",
        "name_prefix": "Mrs.",
        "credential": "AG ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP61298660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AP61298660",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIGIST",
            "last_name": "SEYOUM",
            "middle_name": "EMIRU",
            "prefix": "MRS.",
            "credential": "TIGIST SEYOUM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Acute Care Nurse Practitioner in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Acute Care Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.

Verify at the official NPI Registry.