Provider Demographics
NPI:1912395625
Name:DR. EDWARD H. WASHINGTON JR. PLLC
Entity Type:Organization
Organization Name:DR. EDWARD H. WASHINGTON JR. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:HOLT
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:919-286-9430
Mailing Address - Street 1:PO BOX 2172
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27702-2172
Mailing Address - Country:US
Mailing Address - Phone:919-286-9430
Mailing Address - Fax:919-286-3624
Practice Address - Street 1:623 BROAD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4832
Practice Address - Country:US
Practice Address - Phone:919-286-9430
Practice Address - Fax:919-286-3624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC244373COtherPTAN