Provider Demographics
NPI:1376015271
Name:ADDISON, NATALIA CAUTEVA
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:CAUTEVA
Last Name:ADDISON
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 1:825 10TH ST NW APT 370
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-5081
Mailing Address - Country:US
Mailing Address - Phone:202-262-3488
Mailing Address - Fax:
Practice Address - Street 1:611 FORRESTER ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3539
Practice Address - Country:US
Practice Address - Phone:202-945-3983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant