Provider Demographics
NPI:1790172963
Name:WASHINGTON NEUROLOGY, INC
Entity Type:Organization
Organization Name:WASHINGTON NEUROLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHCARE CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-888-2160
Mailing Address - Street 1:307 S 12TH AVE
Mailing Address - Street 2:SUITE #17
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:307 S 12TH AVE
Practice Address - Street 2:SUITE #17
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3100
Practice Address - Country:US
Practice Address - Phone:509-969-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD602958802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD60295880OtherMEDICAL LICENSE
1477692416OtherINDIVIDUAL NPI