Provider Demographics
NPI:1407512668
Name:WASHINGTON, JOLONDA (RPH)
Entity Type:Individual
Prefix:
First Name:JOLONDA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 MORNINGVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0409
Mailing Address - Country:US
Mailing Address - Phone:704-996-8858
Mailing Address - Fax:
Practice Address - Street 1:6305 MORNINGVIEW CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0409
Practice Address - Country:US
Practice Address - Phone:704-996-8858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist