Provider Demographics
NPI:1356639520
Name:WASHINGTON, EBONY (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:EBONY
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ONEIDA ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1620
Mailing Address - Country:US
Mailing Address - Phone:202-246-5568
Mailing Address - Fax:202-683-4065
Practice Address - Street 1:400 ONEIDA ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1620
Practice Address - Country:US
Practice Address - Phone:202-246-5568
Practice Address - Fax:202-683-4065
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT100000180225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist