Provider Demographics
NPI:1043942386
Name:WELDEGERIMA, MAKIDA YOHANNES
Entity type:Individual
Prefix:
First Name:MAKIDA
Middle Name:YOHANNES
Last Name:WELDEGERIMA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3642 UPTON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-3125
Mailing Address - Country:US
Mailing Address - Phone:202-569-9734
Mailing Address - Fax:
Practice Address - Street 1:3642 UPTON ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-3125
Practice Address - Country:US
Practice Address - Phone:202-569-9734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00164736374U00000X
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide