Lydia Fothi
Individual provider Active NPI Registered Nurse · Kent, WA
NPI 1962050344 · NPPES record last updated Jul 29, 2026
Key facts
- NPI
- 1962050344
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 1679662 (CO)
- Practice address
- 505 Washington Ave S
Kent, WA 98032-5709 - Phone
- (253) 833-7444
- Fax
- (253) 661-8631
- NPI assigned
- Aug 29, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1679662 | CO | Yes |
Addresses
Primary practice location
505 Washington Ave S
Kent, WA 98032-5709
Mailing address
325 W Gowe St
Kent, WA 98032-5892
Phone (253) 833-7444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2153780 | Medicaid | WA |
Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.