Provider Demographics
NPI:1124339288
Name:WASHINGTON, JAMES FARRIS LYNN (PARAMEDIC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FARRIS LYNN
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 114
Mailing Address - Street 2:
Mailing Address - City:MARGARET
Mailing Address - State:AL
Mailing Address - Zip Code:35112-0114
Mailing Address - Country:US
Mailing Address - Phone:205-540-0578
Mailing Address - Fax:
Practice Address - Street 1:453 S NOVASEL ST
Practice Address - Street 2:
Practice Address - City:FORT RUCKER
Practice Address - State:AL
Practice Address - Zip Code:36362-5109
Practice Address - Country:US
Practice Address - Phone:202-726-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9501396146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic