Provider Demographics
NPI:1598796203
Name:WASHO, DAVID (RRT RPSGT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:WASHO
Suffix:
Gender:M
Credentials:RRT RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411
Mailing Address - Country:US
Mailing Address - Phone:570-586-3748
Mailing Address - Fax:570-586-9726
Practice Address - Street 1:108 ABBEY DR
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411
Practice Address - Country:US
Practice Address - Phone:570-586-3748
Practice Address - Fax:570-586-9726
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAYM0035534227900000X
PA6000003565332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0709890001Medicare ID - Type Unspecified