Provider Demographics
NPI:1295092138
Name:MENGESHA, TIRHAS
Entity type:Individual
Prefix:MRS
First Name:TIRHAS
Middle Name:
Last Name:MENGESHA
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 1:1901 E WEST HWY APT 102
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2401
Mailing Address - Country:US
Mailing Address - Phone:240-481-9687
Mailing Address - Fax:
Practice Address - Street 1:1025 THOMAS JEFFERSON ST NW
Practice Address - Street 2:SUITE 180G
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-5201
Practice Address - Country:US
Practice Address - Phone:202-299-1109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-17
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA0984374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide