Provider Demographics
NPI:1265707061
Name:WASHINGTON MEDICAL
Entity type:Organization
Organization Name:WASHINGTON MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATINYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-332-9577
Mailing Address - Street 1:PO BOX 31056
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89173-1056
Mailing Address - Country:US
Mailing Address - Phone:702-332-9577
Mailing Address - Fax:702-255-8199
Practice Address - Street 1:4440 E WASHINGTON AVE STE 109
Practice Address - Street 2:2670 N.LAS VEGAS BLVD SUITE 109, N.LAS VEGAS ,NV 89030
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5793
Practice Address - Country:US
Practice Address - Phone:702-332-9577
Practice Address - Fax:702-255-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty