Provider Demographics
NPI:1992060487
Name:FASIL, YALEMWORK RUFAEL
Entity type:Individual
Prefix:
First Name:YALEMWORK
Middle Name:RUFAEL
Last Name:FASIL
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 1:3501 13TH STREET, NW
Mailing Address - Street 2:APT. 704
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010
Mailing Address - Country:US
Mailing Address - Phone:202-262-8208
Mailing Address - Fax:
Practice Address - Street 1:3501 13TH STREET, NW
Practice Address - Street 2:APT. 704
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-262-8208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide