Provider Demographics
NPI:1295520351
Name:ROSS, AVERY MORRISON
Entity type:Individual
Prefix:
First Name:AVERY
Middle Name:MORRISON
Last Name:ROSS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:AVERY
Other - Middle Name:KATHLEEN
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:DEPT OF OPHTHALMOLOGY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-6732
Mailing Address - Fax:202-877-7743
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:DEPT OF OPHTHALMOLOGY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-6732
Practice Address - Fax:202-877-7743
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program