Provider Demographics
NPI:1407281587
Name:WASHINGTON, PAULA J (RDH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 W BALTIMORE AVE
Mailing Address - Street 2:APT 4C
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-1859
Mailing Address - Country:US
Mailing Address - Phone:267-250-5385
Mailing Address - Fax:
Practice Address - Street 1:555 S 43RD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4408
Practice Address - Country:US
Practice Address - Phone:215-685-7506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH068616124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist