Provider Demographics
NPI:1780215475
Name:MATCHEM, RESHAUN ALEXANDRA
Entity Type:Individual
Prefix:
First Name:RESHAUN
Middle Name:ALEXANDRA
Last Name:MATCHEM
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 1:2345 GREEN ST SE APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-7327
Mailing Address - Country:US
Mailing Address - Phone:202-270-3067
Mailing Address - Fax:
Practice Address - Street 1:2345 GREEN ST SE APT 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7327
Practice Address - Country:US
Practice Address - Phone:202-270-3067
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 Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant