Healthcare Provider Details

I. General information

NPI: 1992697163
Provider Name (Legal Business Name): MR. WAYNE HALL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2641 14TH ST NW APT 203
WASHINGTON DC
20009-7258
US

IV. Provider business mailing address

2641 14TH ST NW APT 203
WASHINGTON DC
20009-7258
US

V. Phone/Fax

Practice location:
  • Phone: 202-390-6567
  • Fax:
Mailing address:
  • Phone: 202-718-5223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number247100000X
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: