Provider Demographics
NPI:1144030842
Name:MOORE-PORTER, DAVONIA PAULETTE
Entity type:Individual
Prefix:
First Name:DAVONIA
Middle Name:PAULETTE
Last Name:MOORE-PORTER
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 1:1301 LENFANT SQ SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-6724
Mailing Address - Country:US
Mailing Address - Phone:202-997-8352
Mailing Address - Fax:
Practice Address - Street 1:1301 LENFANT SQ SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6724
Practice Address - Country:US
Practice Address - Phone:202-997-8352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator