Provider Demographics
NPI:1508744921
Name:WASHINGTON, EDDIE L JR
Entity type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:L
Last Name:WASHINGTON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:EDDIE
Other - Middle Name:L
Other - Last Name:WASHINGTON
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5114 WALDENBROOKE CT NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-5747
Mailing Address - Country:US
Mailing Address - Phone:404-353-8411
Mailing Address - Fax:404-353-8411
Practice Address - Street 1:5114 WALDENBROOKE CT NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-5747
Practice Address - Country:US
Practice Address - Phone:404-353-8411
Practice Address - Fax:404-353-8411
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide