Provider Demographics
NPI:1518359066
Name:THE NEUROLOGY CLINIC OF WASHINGTON
Entity Type:Organization
Organization Name:THE NEUROLOGY CLINIC OF WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TECLA
Authorized Official - Middle Name:T
Authorized Official - Last Name:LALAWNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-260-7600
Mailing Address - Street 1:18111 PRINCE PHILIP DR
Mailing Address - Street 2:SUITE 124
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1513
Mailing Address - Country:US
Mailing Address - Phone:301-260-7600
Mailing Address - Fax:240-779-2111
Practice Address - Street 1:18111 PRINCE PHILIP DR
Practice Address - Street 2:SUITE 124
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1513
Practice Address - Country:US
Practice Address - Phone:301-260-7600
Practice Address - Fax:240-779-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005618364SN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SN0800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeuroscienceGroup - Single Specialty