Provider Demographics
NPI:1134579667
Name:BASHU, SELAMAWIT KEBEDE I
Entity type:Individual
Prefix:MISS
First Name:SELAMAWIT
Middle Name:KEBEDE
Last Name:BASHU
Suffix:I
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SELAMAWIT
Other - Middle Name:KEBEDE
Other - Last Name:BASHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5513 7TH ST NW
Mailing Address - Street 2:5513 7TH ST NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-3021
Mailing Address - Country:US
Mailing Address - Phone:202-718-7737
Mailing Address - Fax:
Practice Address - Street 1:5513 7TH ST NW
Practice Address - Street 2:5513 7TH ST NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-3021
Practice Address - Country:US
Practice Address - Phone:202-718-7737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide