Healthcare Provider Details

I. General information

NPI: 1306755095
Provider Name (Legal Business Name): MEDHIN ENUNE AYELE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 14TH ST NW APT 313E
WASHINGTON DC
20011-5416
US

IV. Provider business mailing address

3800 14TH ST NW APT 313E
WASHINGTON DC
20011-5416
US

V. Phone/Fax

Practice location:
  • Phone: 202-957-5802
  • Fax:
Mailing address:
  • Phone: 202-957-5802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200006905
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: