Individual provider · Type 1 NPI

Bontu Gudeta Kentiba, ARNP

Adult Health Nurse Practitioner · Lacey, WA

NPI number 1902640105 Active

Practice location

605 Woodland Square Loop SE
Lacey, WA 98503-1045

Mailing address

4410 Gallagher Way NW
Olympia, WA 98502-9005

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200XAP70057059 (WA)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1902640105

Bontu Gudeta Kentiba, ARNP's National Provider Identifier is 1902640105, issued on Jun 21, 2024. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Lacey, WA. The record was last updated on Oct 19, 2025.