NPI 1417811498

Samuel Gebremedhn Etay

Practitioner Community Health Worker Meridian, ID

Practice location

Address: 6269 S Aspiration Ave, Meridian, ID 83642-1058
Phone: (970) 449-3655

Registered specialties

Community Health Worker Primary

Other Service Providers Taxonomy 172V00000X Licence NONE (ID)

Other Community Health Worker providers in Idaho →

Registry record

NPI: 1417811498
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Dec 2025
Record last updated: 12 Dec 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.