Provider Demographics
NPI:1053009233
Name:WASHINGTON, TONYA DENISE
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:DENISE
Last Name:WASHINGTON
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 1:63 SAINT LOUIS AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44507-1452
Mailing Address - Country:US
Mailing Address - Phone:330-937-8488
Mailing Address - Fax:
Practice Address - Street 1:63 SAINT LOUIS AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507-1452
Practice Address - Country:US
Practice Address - Phone:330-937-8488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide