Healthcare Provider Details

I. General information

NPI: 1881474021
Provider Name (Legal Business Name): KATUMU MARIAMA SEI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2918 MINNESOTA AVE SE
WASHINGTON DC
20019-1127
US

IV. Provider business mailing address

9400 GRAND BLVD APT 1309
LARGO MD
20774-2646
US

V. Phone/Fax

Practice location:
  • Phone: 202-839-5310
  • Fax:
Mailing address:
  • Phone: 240-246-4243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN968442
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN968442
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: