Provider Demographics
NPI:1083872071
Name:WASHINGTON, SHEILA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2434 INTERSTATE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-3361
Mailing Address - Country:US
Mailing Address - Phone:219-989-3860
Mailing Address - Fax:
Practice Address - Street 1:2434 INTERSTATE PLAZA DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-3361
Practice Address - Country:US
Practice Address - Phone:219-989-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051290075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist