Healthcare Provider Details

I. General information

NPI: 1639097843
Provider Name (Legal Business Name): LINDSAY SHAW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 RESERVOIR RD NW
WASHINGTON DC
20007-2111
US

IV. Provider business mailing address

4000 FAIRFAX DR APT 1708
ARLINGTON VA
22203-1137
US

V. Phone/Fax

Practice location:
  • Phone: 202-687-5974
  • Fax:
Mailing address:
  • Phone: 703-597-5295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001313833
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN500025248
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: