Provider Demographics
NPI:1750868154
Name:BELAY, TIGIST
Entity type:Individual
Prefix:
First Name:TIGIST
Middle Name:
Last Name:BELAY
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 1:2424 WHITE HORSE LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2242
Mailing Address - Country:US
Mailing Address - Phone:703-944-0748
Mailing Address - Fax:
Practice Address - Street 1:1818 NEWTON ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-1017
Practice Address - Country:US
Practice Address - Phone:202-328-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13729374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide