Provider Demographics
NPI:1205543832
Name:HARRIS, DIAMOND TALAYA (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:DIAMOND
Middle Name:TALAYA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 PENNSYLVANIA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:650 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4318
Practice Address - Country:US
Practice Address - Phone:202-547-7797
Practice Address - Fax:202-547-6494
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1744G0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744G0900XOther Service ProvidersSpecialistGraphics Designer