Provider Demographics
NPI:1205556446
Name:WASHINGTON, TAKARA KAMILLE (RN)
Entity type:Individual
Prefix:MS
First Name:TAKARA
Middle Name:KAMILLE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 CALIFORNIA AVE SW APT 203
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-1602
Mailing Address - Country:US
Mailing Address - Phone:540-395-1955
Mailing Address - Fax:
Practice Address - Street 1:1520 CALIFORNIA AVE SW APT 203
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-1602
Practice Address - Country:US
Practice Address - Phone:540-395-1955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61286760163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health