Provider Demographics
NPI:1144587874
Name:SHAW, DIANE (HHA)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 L ST NW
Mailing Address - Street 2:SUITE 900
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-4201
Mailing Address - Country:US
Mailing Address - Phone:202-829-1111
Mailing Address - Fax:
Practice Address - Street 1:3928 SUITLAND RD
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-1926
Practice Address - Country:US
Practice Address - Phone:202-486-0038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant