Provider Demographics
NPI:1780105197
Name:DENEKEW, FENTAYE ADMASSU
Entity type:Individual
Prefix:
First Name:FENTAYE
Middle Name:ADMASSU
Last Name:DENEKEW
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 1:219 UPSHUR ST NW APT 304
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4821
Mailing Address - Country:US
Mailing Address - Phone:202-631-7204
Mailing Address - Fax:
Practice Address - Street 1:219 UPSHUR ST NW APT 304
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4821
Practice Address - Country:US
Practice Address - Phone:202-631-7204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12921374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide