MEDICARE: TSION GEBRESELLASIE DNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	0024174331	VA
2	363LF0000X	Family Nurse Practitioner	0024174331	VA

General Provider Information

NPI Number	:	1134668155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TSION GEBRESELLASIE DNP

Provider Business Mailing Address
First Line	:	101 S WHITING ST STE 104
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-3416
Country	:	US
Telephone Number	:	703-362-3461
Fax Number	:	703-574-7145

Provider Business Practice Location Address
First Line	:	101 S WHITING ST STE 104
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-3416
Country	:	US
Telephone Number	:	703-362-3461
Fax Number	:	703-574-7145

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2017
Last Update Date	:	01/30/2026

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