Provider Demographics
NPI:1821113341
Name:WHITMAN-WALKER CLINIC, INC.
Entity Type:Organization
Organization Name:WHITMAN-WALKER CLINIC, INC.
Other - Org Name:WHITMAN WALKER HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NASEEMA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHAFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-797-3572
Mailing Address - Street 1:1377 R ST NW FL NW2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6293
Mailing Address - Country:US
Mailing Address - Phone:202-745-7000
Mailing Address - Fax:202-797-4412
Practice Address - Street 1:1201 SYCAMORE DR SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-5956
Practice Address - Country:US
Practice Address - Phone:202-745-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QC1500X, 261QD0000X, 261QM0801X, 261QM0850X
DC261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC038947600Medicaid
DC094870800Medicaid
DC19094OtherCHARTERED ALLIANCE
DC094518400Medicaid
DC5590OtherHEALTH RIGHT INC.