Provider Demographics
NPI:1598377632
Name:DAVIS, SHA'QUALE
Entity Type:Individual
Prefix:
First Name:SHA'QUALE
Middle Name:
Last Name:DAVIS
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 1:301 TINGEY STREET SE
Mailing Address - Street 2:301 TINGEY STREET SE #203
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4611
Mailing Address - Country:US
Mailing Address - Phone:202-830-8319
Mailing Address - Fax:
Practice Address - Street 1:301 TINGEY STREET SE
Practice Address - Street 2:301 TINGEY STREET SE #203
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4611
Practice Address - Country:US
Practice Address - Phone:202-830-8319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide