Provider Demographics
NPI:1013200294
Name:TAKELE, WOINSHET (RPH)
Entity Type:Individual
Prefix:
First Name:WOINSHET
Middle Name:
Last Name:TAKELE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:WOINSHET
Other - Middle Name:
Other - Last Name:TAKELE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:42415 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4857
Mailing Address - Country:US
Mailing Address - Phone:703-542-8304
Mailing Address - Fax:703-542-8311
Practice Address - Street 1:42415 RYAN RD
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-4857
Practice Address - Country:US
Practice Address - Phone:703-542-8304
Practice Address - Fax:703-542-8311
Is Sole Proprietor?:No
Enumeration Date:2011-05-22
Last Update Date:2011-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201004049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist