Healthcare Provider Details

I. General information

NPI: 1851978696
Provider Name (Legal Business Name): WAKAKO HORIUCHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST. NW DEPT OF OBSTETRICS AND GYNECOLOGY
WASHINGTON DC
20010
US

IV. Provider business mailing address

110 IRVING ST. NW DEPT OF OBSTETRICS AND GYNECOLOGY
WASHINGTON DC
20010
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-8035
  • Fax: 202-877-5435
Mailing address:
  • Phone: 202-877-8035
  • Fax: 202-877-5435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD600004478
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0104064
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: