Provider Demographics
NPI:1215681069
Name:TCHUISSEU YOUMBI, GISELE
Entity type:Individual
Prefix:
First Name:GISELE
Middle Name:
Last Name:TCHUISSEU YOUMBI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 WISCONSIN AVE NW STE 100
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4118
Mailing Address - Country:US
Mailing Address - Phone:240-812-9434
Mailing Address - Fax:
Practice Address - Street 1:5028 WISCONSIN AVE NW STE 100
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4118
Practice Address - Country:US
Practice Address - Phone:240-812-9434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18120183500000X
VA0202208719183500000X
DCPH100000502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist