Provider Demographics
NPI:1801044243
Name:WASHINGTON, STUART (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 HARRISON ST
Mailing Address - Street 2:SOUTH OF MARKET CLINIC
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1235
Mailing Address - Country:US
Mailing Address - Phone:415-254-6266
Mailing Address - Fax:
Practice Address - Street 1:760 HARRISON ST
Practice Address - Street 2:SOUTH OF MARKET CLINIC
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1235
Practice Address - Country:US
Practice Address - Phone:415-254-6266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC959412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry