Healthcare Provider Details

I. General information

NPI: 1154349025
Provider Name (Legal Business Name): WASHINGTON ENT GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 M ST NW SUITE# 620
WASHINGTON DC
20037-1404
US

IV. Provider business mailing address

2440 M ST NW SUITE# 620
WASHINGTON DC
20037-1404
US

V. Phone/Fax

Practice location:
  • Phone: 202-785-5000
  • Fax: 202-785-5040
Mailing address:
  • Phone: 202-785-5000
  • Fax: 202-785-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD17380
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberMD17380
License Number StateDC

VIII. Authorized Official

Name: DR. CATHERINE A. PICKEN
Title or Position: OWNER
Credential: M.D.
Phone: 202-785-5000