Healthcare Provider Details

I. General information

NPI: 1386571198
Provider Name (Legal Business Name): SHAMARI M DOUGLASS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 13TH ST NE
WASHINGTON DC
20018-1122
US

IV. Provider business mailing address

400 WARFIELD DR APT 3071
HYATTSVILLE MD
20785-4590
US

V. Phone/Fax

Practice location:
  • Phone: 202-486-4259
  • Fax:
Mailing address:
  • Phone: 202-465-1729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: