Provider Demographics
NPI:1851866198
Name:WASHINGTON MEDICAL LLC
Entity Type:Organization
Organization Name:WASHINGTON MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-854-4052
Mailing Address - Street 1:1140 VARNUM ST NE STE 203
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2153
Mailing Address - Country:US
Mailing Address - Phone:202-854-4052
Mailing Address - Fax:202-854-4832
Practice Address - Street 1:1140 VARNUM ST NE STE 203
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2153
Practice Address - Country:US
Practice Address - Phone:202-854-4052
Practice Address - Fax:202-854-4832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty