Provider Demographics
NPI:1538846555
Name:ABUSHET, LIDIA GOLA (BSN)
Entity type:Individual
Prefix:
First Name:LIDIA
Middle Name:GOLA
Last Name:ABUSHET
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 SW 154TH ST APT 108
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2334
Mailing Address - Country:US
Mailing Address - Phone:206-446-7023
Mailing Address - Fax:
Practice Address - Street 1:233 SW 154TH ST APT 108
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2334
Practice Address - Country:US
Practice Address - Phone:206-446-7023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61185822163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse