Provider Demographics
NPI:1154096402
Name:BELAYNEH, TSIGEREDA
Entity Type:Individual
Prefix:
First Name:TSIGEREDA
Middle Name:
Last Name:BELAYNEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7008 LITTLE RIVER TPKE STE G
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3234
Mailing Address - Country:US
Mailing Address - Phone:703-333-3113
Mailing Address - Fax:703-995-4548
Practice Address - Street 1:7008 LITTLE RIVER TPKE STE G
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3234
Practice Address - Country:US
Practice Address - Phone:703-333-3113
Practice Address - Fax:703-995-4548
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001157671163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)