Provider Demographics
NPI:1568069565
Name:EASTON, MARQUE LEJAUN
Entity Type:Individual
Prefix:
First Name:MARQUE
Middle Name:LEJAUN
Last Name:EASTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 21ST ST NE # E200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3150
Mailing Address - Country:US
Mailing Address - Phone:202-853-3780
Mailing Address - Fax:
Practice Address - Street 1:1108 21ST ST NE APT 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3170
Practice Address - Country:US
Practice Address - Phone:202-853-3780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-03
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant