Healthcare Provider Details

I. General information

NPI: 1639433808
Provider Name (Legal Business Name): MASAZEW NDEDSEH MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 15TH ST NE
WASHINGTON DC
20002-4508
US

IV. Provider business mailing address

702 15TH ST NE
WASHINGTON DC
20002-4508
US

V. Phone/Fax

Practice location:
  • Phone: 202-388-8500
  • Fax: 202-503-2363
Mailing address:
  • Phone: 202-388-8500
  • Fax: 202-503-2363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG200004419
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: