Provider Demographics
NPI:1457067845
Name:WASHINGTON, SCHALACY SCHARELL
Entity Type:Individual
Prefix:
First Name:SCHALACY
Middle Name:SCHARELL
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TRAVIS ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2447
Mailing Address - Country:US
Mailing Address - Phone:337-660-4663
Mailing Address - Fax:
Practice Address - Street 1:200 TRAVIS ST STE 165
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2447
Practice Address - Country:US
Practice Address - Phone:337-660-4663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA229386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily