NPI 1407422033 · live from the CMS NPI Registry
Enatalem Getachew Ejerssa
Massage Therapist in Fort Washington, MD. National Provider Identifier 1407422033, active.
NPI record
| NPI | 1407422033 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 1215 Palmer Rd Apt 1, Fort Washington, MD 20744 |
| Practice phone | 510-692-2053 |
| Enumerated | June 3, 2021 |
| Last updated | June 3, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Nurse Massage Therapist (NMT) | 163WM1400X | 0019017981 (VA) |
| Massage Therapist primary | 225700000X | R02544 (MD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.