Provider Demographics
NPI:1295709723
Name:WASHINGTON, KAREN L (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 639972
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9972
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:930 W 21ST ST STE 100
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1516
Practice Address - Country:US
Practice Address - Phone:757-622-8358
Practice Address - Fax:757-622-9662
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010097495Medicaid
VA541595397OtherMID ATLANTIC SOLUTIONS
VA541595397OtherPRIVATE HEALTHCARE SYSTEM
VA122066OtherSENTARA/OPTIMA
VA7786673OtherAETNA
VA146341OtherANTHEM
VA541595397OtherVIRGINIA HEALTH NETWORK
VAI19472Medicare UPIN
VA146341OtherANTHEM