Provider Demographics
NPI:1114581048
Name:ASSEFA, TIGIST N/A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIGIST
Middle Name:N/A
Last Name:ASSEFA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 S THOMAS ST APT 21
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-3674
Mailing Address - Country:US
Mailing Address - Phone:703-991-3848
Mailing Address - Fax:
Practice Address - Street 1:490 L ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2545
Practice Address - Country:US
Practice Address - Phone:202-719-2439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist