Provider Demographics
NPI:1487133104
Name:ESHETE, SISAY ASMARE
Entity type:Individual
Prefix:
First Name:SISAY
Middle Name:ASMARE
Last Name:ESHETE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 13TH ST NW APT 301
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-3574
Mailing Address - Country:US
Mailing Address - Phone:202-840-4425
Mailing Address - Fax:
Practice Address - Street 1:5616 13TH ST NW APT 301
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-3574
Practice Address - Country:US
Practice Address - Phone:202-840-4425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13893374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide