Provider Demographics
NPI:1659639375
Name:ALEMAYEHU, ADDIS
Entity Type:Individual
Prefix:
First Name:ADDIS
Middle Name:
Last Name:ALEMAYEHU
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 1:1025 THOMAS JEFFERSON ST NW STE 180G
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-5209
Mailing Address - Country:US
Mailing Address - Phone:202-299-1109
Mailing Address - Fax:
Practice Address - Street 1:1025 THOMAS JEFFERSON ST NW STE 180G
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-5209
Practice Address - Country:US
Practice Address - Phone:202-299-1109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide