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Contact Information

ENATALEM G EJERSSA
1215 PALMER RD APT 1
FORT WASHINGTON, MD20744-7143
 Phone: 510-692-2053
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Massage Therapist

225700000X
 

Nurse Massage Therapist (NMT)

163WM1400X
Indicates primary specialty

NPI Profile & details for ENATALEM G EJERSSA · (Female)

NPI Number 1407422033
Status Active
Credentials
Entity Individual
Enumeration date 06/03/2021
Last updated 06/03/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • MD License # R02544
  • VA License # 0019017981
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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