Provider Demographics
NPI:1043699150
Name:WASHINGTON, ALAN JAY
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:JAY
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E. MAIN
Mailing Address - Street 2:RESOURCE MANAGEMENT
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820
Mailing Address - Country:US
Mailing Address - Phone:580-436-7211
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:3200 MARSHALL AVE. OUTPATIENT SERVICES-NORMAN
Practice Address - Street 2:SUITE 220 STRONG FAMILY DEVELOPMENT
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072
Practice Address - Country:US
Practice Address - Phone:405-767-8940
Practice Address - Fax:405-767-8949
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker