Provider Demographics
NPI:1952958829
Name:ENDRIS, FAIZA YIMER
Entity Type:Individual
Prefix:
First Name:FAIZA
Middle Name:YIMER
Last Name:ENDRIS
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 1:6808 KINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3808
Mailing Address - Country:US
Mailing Address - Phone:443-716-5481
Mailing Address - Fax:
Practice Address - Street 1:4201 CATHEDRAL AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4901
Practice Address - Country:US
Practice Address - Phone:650-759-8287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-24
Last Update Date:2019-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant