Provider Demographics
NPI:1265698112
Name:WASHINGTON, SHALANDA TENA (PHARMD, MS, BCACP)
Entity type:Individual
Prefix:DR
First Name:SHALANDA
Middle Name:TENA
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:PHARMD, MS, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:144 SHENANDOAH RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-3428
Mailing Address - Country:US
Mailing Address - Phone:757-291-7412
Mailing Address - Fax:757-767-7502
Practice Address - Street 1:800 ZORN AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1433
Practice Address - Country:US
Practice Address - Phone:757-291-7412
Practice Address - Fax:757-767-7502
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS439381835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care