Provider Demographics
NPI:1881201234
Name:WASHINGTON, TAMARA GENEAN (CNA)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:GENEAN
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5020 ALTA DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3940
Mailing Address - Country:US
Mailing Address - Phone:702-685-3418
Mailing Address - Fax:
Practice Address - Street 1:3953 YELLOW MANDARIN AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-4019
Practice Address - Country:US
Practice Address - Phone:702-541-3144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider