Provider Demographics
NPI:1124526702
Name:WASHINGTON, RAMON ALVIS
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:ALVIS
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 1:2800 YOUREE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-3660
Mailing Address - Country:US
Mailing Address - Phone:318-210-0928
Mailing Address - Fax:318-425-9644
Practice Address - Street 1:2800 YOUREE DR STE 301
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-3660
Practice Address - Country:US
Practice Address - Phone:318-210-0928
Practice Address - Fax:318-425-9644
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health