Provider Demographics
NPI:1568939528
Name:SHAW, GERRI E
Entity Type:Individual
Prefix:MISS
First Name:GERRI
Middle Name:E
Last Name:SHAW
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 1:3519 MINNESOTA AVE SE APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-8268
Mailing Address - Country:US
Mailing Address - Phone:202-415-0178
Mailing Address - Fax:
Practice Address - Street 1:1900 MASSACHUSETTS AVE SE BLDG 13
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2542
Practice Address - Country:US
Practice Address - Phone:202-682-6592
Practice Address - Fax:202-543-2115
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty