Provider Demographics
NPI:1902419112
Name:WASHINGTON, QUELYNDRIA
Entity Type:Individual
Prefix:
First Name:QUELYNDRIA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11740 NORTHPOINTE BLVD APT 706
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-6081
Mailing Address - Country:US
Mailing Address - Phone:832-206-3618
Mailing Address - Fax:
Practice Address - Street 1:11740 NORTHPOINTE BLVD APT 706
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-6081
Practice Address - Country:US
Practice Address - Phone:832-206-3618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9879376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator