Provider Demographics
NPI:1770283780
Name:WINCHESTER, TARIKA (LMT, CMMP)
Entity type:Individual
Prefix:
First Name:TARIKA
Middle Name:
Last Name:WINCHESTER
Suffix:
Gender:F
Credentials:LMT, CMMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CONNECTICUT AVE NW STE 401
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5529
Mailing Address - Country:US
Mailing Address - Phone:202-744-0316
Mailing Address - Fax:
Practice Address - Street 1:1001 CONNECTICUT AVE NW STE 401
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5529
Practice Address - Country:US
Practice Address - Phone:202-744-0316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMT1924225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist