Healthcare Provider Details

I. General information

NPI: 1922919240
Provider Name (Legal Business Name): ETAFERAHU WORKU YITAYEW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 GEORGIA AVE NW
WASHINGTON DC
20012-2546
US

IV. Provider business mailing address

6650 GEORGIA AVE NW
WASHINGTON DC
20012-2546
US

V. Phone/Fax

Practice location:
  • Phone: 202-823-5300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: