Healthcare Provider Details

I. General information

NPI: 1164386199
Provider Name (Legal Business Name): MERON TAREKEGNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 BUCHANAN ST NE
WASHINGTON DC
20017-2340
US

IV. Provider business mailing address

5120 N CAPITOL ST NW
WASHINGTON DC
20011-6712
US

V. Phone/Fax

Practice location:
  • Phone: 202-854-2001
  • Fax:
Mailing address:
  • Phone: 202-854-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224ZR0403X
TaxonomyDriving and Community Mobility Occupational Therapy Assistant
License Number100000283
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: