Provider Demographics
NPI:1982875712
Name:WASHINGTON, TRACY P (CADAC)
Entity Type:Individual
Prefix:MR
First Name:TRACY
Middle Name:P
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:CADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 SIGNER BLVD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818
Mailing Address - Country:US
Mailing Address - Phone:808-449-0185
Mailing Address - Fax:
Practice Address - Street 1:750 SIGNER BLVD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818
Practice Address - Country:US
Practice Address - Phone:808-449-0185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)