Provider Demographics
NPI:1073879052
Name:WASHINGTON, DELOIS ANN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DELOIS
Middle Name:ANN
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 MARTIN DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-2045
Mailing Address - Country:US
Mailing Address - Phone:720-338-4640
Mailing Address - Fax:
Practice Address - Street 1:2600 REDMAN RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-5863
Practice Address - Country:US
Practice Address - Phone:314-900-0572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016040343213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist