Healthcare Provider Details

I. General information

NPI: 1588334239
Provider Name (Legal Business Name): MS. YOKABED R GEBREHIWET
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2021
Last Update Date: 09/15/2021
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 UPSHUR ST NW APT 505
WASHINGTON DC
20011-5658
US

IV. Provider business mailing address

3636 16TH ST NW APT B709
WASHINGTON DC
20010-1121
US

V. Phone/Fax

Practice location:
  • Phone: 202-469-2434
  • Fax:
Mailing address:
  • Phone: 202-276-8531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: