Healthcare Provider Details

I. General information

NPI: 1912330192
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF METROPOLITAN WASHINGTON DC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2013
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19650 CLUB HOUSE RD # 101
MONTGOMERY VILLAGE MD
20886-3003
US

IV. Provider business mailing address

1225 4TH ST NE
WASHINGTON DC
20002-3431
US

V. Phone/Fax

Practice location:
  • Phone: 202-347-8512
  • Fax:
Mailing address:
  • Phone: 202-347-8512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAKINA WILSON
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 410-591-4273