Provider Demographics
NPI:1386395408
Name:WASHINGTON, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 BROADWAY STE H
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7006
Mailing Address - Country:US
Mailing Address - Phone:219-769-7710
Mailing Address - Fax:219-769-7758
Practice Address - Street 1:8500 BROADWAY STE H
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7006
Practice Address - Country:US
Practice Address - Phone:219-769-7710
Practice Address - Fax:219-769-7758
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27042610A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse