Provider Demographics
NPI:1710518436
Name:WOLDEMARIAM, NETSANET TENKER
Entity Type:Individual
Prefix:
First Name:NETSANET
Middle Name:TENKER
Last Name:WOLDEMARIAM
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 1:6040 13TH PL NW APT 306
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5034
Mailing Address - Country:US
Mailing Address - Phone:202-847-7749
Mailing Address - Fax:
Practice Address - Street 1:6040 13TH PL NW APT 306
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5034
Practice Address - Country:US
Practice Address - Phone:202-847-7749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14666374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide