Provider Demographics
NPI:1801628748
Name:WASHINGTON, JARED ISIAH
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:ISIAH
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4943 PIETY DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-3546
Mailing Address - Country:US
Mailing Address - Phone:337-255-2507
Mailing Address - Fax:
Practice Address - Street 1:3301 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6247
Practice Address - Country:US
Practice Address - Phone:504-644-2575
Practice Address - Fax:504-644-2803
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator