Provider Demographics
NPI:1235381245
Name:WASHINGTON, RACHELLE LOGWOOD (RT)
Entity Type:Individual
Prefix:MS
First Name:RACHELLE
Middle Name:LOGWOOD
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 MEDIAMOLLE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-3436
Mailing Address - Country:US
Mailing Address - Phone:504-258-9606
Mailing Address - Fax:
Practice Address - Street 1:2100 MEDIAMOLLE DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-3436
Practice Address - Country:US
Practice Address - Phone:504-258-9606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2077247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist