Individual provider Active NPI

Kelemwa H Menegesha

  • Adult Care Home Facility
  • Federal Way, WA
National Provider Identifier
1932045317
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
758241 Issued in WA
Practice address
34259 36TH PL SW
Federal Way, WA 98023-2941
Phone
(206) 302-8490
Fax
(253) 235-5780
NPI assigned
Apr 27, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 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 758241 WA Primary

Addresses

Primary practice location

34259 36TH PL SW
Federal Way, WA 98023-2941

Mailing address

34259 36TH PL SW
Federal Way, WA 98023-2941
Phone (206) 302-8490

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
758241WAMDAdult Care Home Facility

NPI Registry JSON

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1932045317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34259 36TH PL SW",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232941",
            "telephone_number": "206-302-8490",
            "fax_number": "253-235-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34259 36TH PL SW",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232941",
            "telephone_number": "206-302-8490",
            "fax_number": "253-235-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENEGESHA",
        "first_name": "KELEMWA",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WA",
            "license": "758241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.