Active NPI
Licha Habttie
- Home Health Aide
- Edmonds, WA
National Provider Identifier
1730939430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 756373
- Practice address
- 14231 55TH Ave W
Edmonds, WA 98026-3814 - Phone
- (206) 335-0057
- Fax
- (425) 678-8002
- NPI assigned
- Mar 25, 2024
- Last updated
- Mar 25, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 756373 | WA | Primary |
Addresses
Primary practice location
14231 55TH Ave W
Edmonds, WA 98026-3814
Mailing address
14231 55TH Ave W
Edmonds, WA 98026-3814
Phone (206) 335-0057
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 |
|---|---|---|---|
| 756373 | WA | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1730939430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14231 55TH AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980263814",
"telephone_number": "206-335-0057",
"fax_number": "425-678-8002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14231 55TH AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980263814",
"telephone_number": "206-335-0057",
"fax_number": "425-678-8002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HABTTIE",
"first_name": "LICHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-25",
"last_updated": "2024-03-25",
"certification_date": "2024-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "WA",
"license": "756373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.