Healthcare Provider Details

I. General information

NPI: 1174452106
Provider Name (Legal Business Name): DONITA M PORTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4422 1ST ST NE
WASHINGTON DC
20011-4909
US

IV. Provider business mailing address

4422 1ST ST NE
WASHINGTON DC
20011-4909
US

V. Phone/Fax

Practice location:
  • Phone: 202-498-3859
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200006494
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: