Healthcare Provider Details

I. General information

NPI: 1700742848
Provider Name (Legal Business Name): DR. JAMES EVAN WATSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW STE 1300
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

111 MICHIGAN AVE NW STE 1300
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-4265
  • Fax:
Mailing address:
  • Phone: 202-476-4265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT210002480
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: