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General NPI Number Information
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NPI Number | 1831024769
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Entity Type | Individual
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Provider Name | OLUWADEMILADE ELIZABETH FAJEMISIN
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Gender | Female
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Dates
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Enumeration Date | 06/13/2026
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Last Update Date | 06/13/2026
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Provider Practice Location Address
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Address Line | 1040 S HENDERSON ST
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City | SEATTLE
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State | WA
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Zip | 98108-4720
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Country | US
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Telephone | 206-763-5277
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Fax |
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Provider Business Mailing Address
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Address Line | 5328 CRITTENDEN ST
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City | HYATTSVILLE
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State | MD
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Zip | 20781-2633
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Country | US
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Telephone | 240-815-9555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R249901
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License Number State | MD
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