Provider Demographics
NPI:1962631093
Name:WASHINGTON, LISA ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANN
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 CABIN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17406-8615
Mailing Address - Country:US
Mailing Address - Phone:443-772-0797
Mailing Address - Fax:
Practice Address - Street 1:2821 E PROSPECT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-9213
Practice Address - Country:US
Practice Address - Phone:717-840-1874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22987225100000X
PAPT020442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist