Individual provider Active NPI

Tselot Woldegiorgis, RN

  • Registered Nurse
  • Kent, WA
National Provider Identifier
1922498450
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60174822 Issued in WA
Practice address
21722 129TH CT SE
Kent, WA 98031-3944
Phone
(206) 412-3280
NPI assigned
Feb 4, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60174822 WA Primary

Addresses

Primary practice location

21722 129TH CT SE
Kent, WA 98031-3944

Mailing address

21722 129TH CT SE
Kent, WA 98031-3944
Phone (206) 412-3280

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60174822WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1922498450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21722 129TH CT SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980313944",
            "telephone_number": "206-412-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21722 129TH CT SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980313944",
            "telephone_number": "206-412-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDEGIORGIS",
        "first_name": "TSELOT",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60174822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.