Provider Demographics
NPI:1043303696
Name:WASHINGTON, TABITHA ANTOINETTE (MD, BS)
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:ANTOINETTE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MD, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC DEPARTMENT OF ANESTHESIOLOGY, PAIN MEDICINE
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-6040
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC DEPARTMENT OF ANESTHESIOLOGY, PAIN MEDICINE
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-6040
Practice Address - Fax:603-650-8199
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH13648207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1014056Medicaid
NH30207153Medicaid
VT1014056Medicaid
NH000249801Medicare PIN