Provider Demographics
NPI:1679253561
Name:NIMELY, SAYDAH
Entity type:Individual
Prefix:
First Name:SAYDAH
Middle Name:
Last Name:NIMELY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 N 10TH PL
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5570
Mailing Address - Country:US
Mailing Address - Phone:206-586-7674
Mailing Address - Fax:
Practice Address - Street 1:1202 N 10TH PL
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5570
Practice Address - Country:US
Practice Address - Phone:206-586-7674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant