Healthcare Provider Details

I. General information

NPI: 1063345726
Provider Name (Legal Business Name): NATAN GEBREMARIAM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4656 LIVINGSTON RD SE
WASHINGTON DC
20032-3149
US

IV. Provider business mailing address

2700 DORR AVE
FAIRFAX VA
22031-4936
US

V. Phone/Fax

Practice location:
  • Phone: 202-519-0982
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT210002525
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: