Bontu Gudeta Kentiba, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP70057059 Issued in WA

Practice address

605 Woodland Square Loop SE
Lacey, WA 98503-1045

Phone

(360) 764-8000

NPI assigned

Jun 21, 2024

Sex

Unspecified or another gender identity

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vest Thurston LLCGroup PAC ID 0648512459, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vest Thurston LLC

  • Psychiatric Hospital
  • Lacey, WA
  • NPI 1336605849
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760832000000",
    "number": "1902640105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 GALLAGHER WAY NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985029005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 WOODLAND SQUARE LOOP SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031045",
            "telephone_number": "360-764-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENTIBA",
        "first_name": "BONTU",
        "middle_name": "GUDETA",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2024-06-21",
        "last_updated": "2025-10-19",
        "certification_date": "2025-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP70057059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Kelley
• Sara Kemp, SLP
• Megan Kendig
• Jennifer D Kennedy, PSYD
• Kenneth W Trapp DC Inc
• Kevala Counseling, LLC
• Key Counseling PLLC
• Prachanda Khadka, NP
• Guru Parkash Khalsa
• Khy Optometry & Associates, PLLC

• Adult Health Nurse Practitioner in Lacey, WA
• Providers in Lacey, WA by specialty
• Adult Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.