Provider Demographics
NPI:1508152059
Name:WASHINGTON, TAMRA LYNN (MED, BHRS)
Entity Type:Individual
Prefix:
First Name:TAMRA
Middle Name:LYNN
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MED, BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 NW 160TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2039
Mailing Address - Country:US
Mailing Address - Phone:405-921-9218
Mailing Address - Fax:405-521-4373
Practice Address - Street 1:109 NW 160TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-2039
Practice Address - Country:US
Practice Address - Phone:405-921-9218
Practice Address - Fax:405-521-4373
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency