Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Providence Health Services, Inc

Organization Otolaryngology Physician · NPI 1366710766

Providence Health Services, Inc is an Otolaryngology Physician in Washington, District of Columbia. Licensed in District of Columbia. Registered with an NPI since 2011.

Licensed in
DC
In the registry since
2011
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1140 Varnum St NE Pmb 200
Washington, DC 20017-2151
Phone: (202) 854-4355
Fax: (202) 854-4398
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence HFD01-0212 (DC)
General Acute Care Hospital Taxonomy 282N00000X · Licence HFD01-0212 (DC)

Record details

NPI number1366710766
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Hospital
Authorized official Beau Higginbothan — Vice President/Coo · (410) 368-3182
Other names Phs Otolaryngology Pmb200
NPI enumeratedDecember 13, 2011
Last updated in NPPESFebruary 1, 2018
Mailing address1160 Varnum St Ne, St Catherine'S Hall, Room 102, Washington, DC 20017-2107

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