Provider Demographics
NPI:1932454535
Name:SOH, WENDY N
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:N
Last Name:SOH
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 1:7826 EASTERN AVE NW STE 206
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1333
Mailing Address - Country:US
Mailing Address - Phone:301-221-3036
Mailing Address - Fax:
Practice Address - Street 1:7826 EASTERN AVE NW STE 206
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1333
Practice Address - Country:US
Practice Address - Phone:202-810-5454
Practice Address - Fax:202-810-4143
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP1046169363LP0808X, 163WP0809X
DCRN1046169163W00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No374U00000XNursing Service Related ProvidersHome Health Aide