Provider Demographics
NPI:1952850794
Name:WASHINGTON, KALEY RAE
Entity Type:Individual
Prefix:MISS
First Name:KALEY
Middle Name:RAE
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 1:6100 N BROOKLINE AVE
Mailing Address - Street 2:APT 32
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-3901
Mailing Address - Country:US
Mailing Address - Phone:405-474-4500
Mailing Address - Fax:
Practice Address - Street 1:6100 N BROOKLINE AVE
Practice Address - Street 2:APT 32
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3901
Practice Address - Country:US
Practice Address - Phone:405-474-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist