Provider Demographics
NPI:1306494364
Name:WOLDEARGHAI, BRIZAFF
Entity type:Individual
Prefix:
First Name:BRIZAFF
Middle Name:
Last Name:WOLDEARGHAI
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 1:2540 MASSACHUSETTS AVE NW APT A-1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-2843
Mailing Address - Country:US
Mailing Address - Phone:202-306-1891
Mailing Address - Fax:
Practice Address - Street 1:2540 MASSACHUSETTS AVE NW APT A-1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2843
Practice Address - Country:US
Practice Address - Phone:202-306-1891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14579374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide