Provider Demographics
NPI:1417405747
Name:TILAHUN, TSION
Entity Type:Individual
Prefix:
First Name:TSION
Middle Name:
Last Name:TILAHUN
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 1:820 UPSHUR ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5837
Mailing Address - Country:US
Mailing Address - Phone:202-723-0304
Mailing Address - Fax:202-723-0367
Practice Address - Street 1:6115 QUEBEC PL
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2741
Practice Address - Country:US
Practice Address - Phone:571-620-4779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12226374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide