Healthcare Provider Details

I. General information

NPI: 1386508109
Provider Name (Legal Business Name): SADE WASHINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5114 D ST SE
WASHINGTON DC
20019-6121
US

IV. Provider business mailing address

5114 D ST SE
WASHINGTON DC
20019-6121
US

V. Phone/Fax

Practice location:
  • Phone: 240-845-4293
  • Fax:
Mailing address:
  • Phone: 240-845-4293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number4230960
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: