Provider Demographics
NPI:1366086431
Name:JIMMA, AZALECH (NURSE)
Entity type:Individual
Prefix:MRS
First Name:AZALECH
Middle Name:
Last Name:JIMMA
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:AZALECH
Other - Middle Name:
Other - Last Name:ADEBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10051 NE 33RD STREET
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-1929
Mailing Address - Country:US
Mailing Address - Phone:425-828-3941
Mailing Address - Fax:
Practice Address - Street 1:10051 NE 33RD STREET
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-1929
Practice Address - Country:US
Practice Address - Phone:425-828-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider