Provider Demographics
NPI:1376078469
Name:MOORER, DAJA
Entity Type:Individual
Prefix:
First Name:DAJA
Middle Name:
Last Name:MOORER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3322 14TH PL SE
Mailing Address - Street 2:302
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4711
Mailing Address - Country:US
Mailing Address - Phone:202-531-8166
Mailing Address - Fax:
Practice Address - Street 1:3322 14TH PL SE
Practice Address - Street 2:APT#302
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032
Practice Address - Country:US
Practice Address - Phone:202-531-8166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3814341374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide