Provider Demographics
NPI:1548020621
Name:TSAGUE, DORETTE (HHA)
Entity type:Individual
Prefix:
First Name:DORETTE
Middle Name:
Last Name:TSAGUE
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 4TH ST NE APT 304
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1292
Mailing Address - Country:US
Mailing Address - Phone:301-728-9658
Mailing Address - Fax:
Practice Address - Street 1:2321 4TH ST NE APT 304
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1292
Practice Address - Country:US
Practice Address - Phone:301-728-9658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide