Provider Demographics
NPI:1730764341
Name:DOLAAL, NESTEHA
Entity type:Individual
Prefix:
First Name:NESTEHA
Middle Name:
Last Name:DOLAAL
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 1:732 140TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3726
Mailing Address - Country:US
Mailing Address - Phone:206-981-9209
Mailing Address - Fax:206-237-9121
Practice Address - Street 1:732 140TH AVE SE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3726
Practice Address - Country:US
Practice Address - Phone:206-981-9209
Practice Address - Fax:206-237-9121
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604620883374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide