Provider Demographics
NPI:1932964673
Name:WASHINGTON, SHANDON TERRION (MAT)
Entity Type:Individual
Prefix:MRS
First Name:SHANDON
Middle Name:TERRION
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7434 MACEDONIA RD
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44146-6264
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7434 MACEDONIA RD
Practice Address - Street 2:
Practice Address - City:OAKWOOD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44146-6264
Practice Address - Country:US
Practice Address - Phone:216-282-6826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator