Provider Demographics
NPI:1487280004
Name:DANIEL, TARIKAWE ASHENAFI
Entity type:Individual
Prefix:
First Name:TARIKAWE
Middle Name:ASHENAFI
Last Name:DANIEL
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 1:4600 DUKE ST APT 1525
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-2513
Mailing Address - Country:US
Mailing Address - Phone:571-234-3158
Mailing Address - Fax:
Practice Address - Street 1:4600 DUKE ST APT 1525
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2513
Practice Address - Country:US
Practice Address - Phone:571-234-3158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-15
Last Update Date:2020-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant