Provider Demographics
NPI:1629734728
Name:YUSHAU, OLAIDE BARSIRAH
Entity Type:Individual
Prefix:
First Name:OLAIDE
Middle Name:BARSIRAH
Last Name:YUSHAU
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 1:3402 554TH AVE. SUITE 204
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784
Mailing Address - Country:US
Mailing Address - Phone:240-413-9412
Mailing Address - Fax:
Practice Address - Street 1:2606 18THST SE APT C
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2002
Practice Address - Country:US
Practice Address - Phone:706-621-0469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant