Provider Demographics
NPI:1639618788
Name:WASHINGTON, HENRY ERIC
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:ERIC
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 ESHER PL
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-6709
Mailing Address - Country:US
Mailing Address - Phone:504-915-2733
Mailing Address - Fax:
Practice Address - Street 1:1924 ESHER PL
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-6709
Practice Address - Country:US
Practice Address - Phone:504-915-2733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator