Provider Demographics
NPI:1255135554
Name:WASHINGTON, ALYESE
Entity type:Individual
Prefix:
First Name:ALYESE
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13713 HOOK CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1813
Mailing Address - Country:US
Mailing Address - Phone:347-752-8418
Mailing Address - Fax:
Practice Address - Street 1:1105 MONTLIEU AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3534
Practice Address - Country:US
Practice Address - Phone:336-819-2910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program