Provider Demographics
NPI:1114520897
Name:BELAYNEH, HELAWE KETEMA (RPH)
Entity Type:Individual
Prefix:MR
First Name:HELAWE
Middle Name:KETEMA
Last Name:BELAYNEH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 BYRON ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2609
Mailing Address - Country:US
Mailing Address - Phone:202-785-3102
Mailing Address - Fax:202-785-2861
Practice Address - Street 1:1025 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5405
Practice Address - Country:US
Practice Address - Phone:202-785-2861
Practice Address - Fax:202-785-3102
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25744183500000X
DCPH100001355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist