| Theressia L Washington Md Pc | |
|
1355 N Sierra Bonita Ave Apt 206 West Hollywood CA 90046-8516 | |
| (310) 275-8377 | |
| (310) 276-8377 |
| Full Name | Theressia L Washington Md Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1355 N Sierra Bonita Ave Apt 206, West Hollywood, California |
| Authorized Official Name and Position | Theressia Louise Washington (PRESIDENT/CEO) |
| Authorized Official Contact | 3102758377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theressia L Washington Md Pc 9663 Santa Monica Blvd Ste 957 Beverly Hills CA 90210-4303 Ph: (310) 275-8377 | Theressia L Washington Md Pc 1355 N Sierra Bonita Ave Apt 206 West Hollywood CA 90046-8516 Ph: (310) 275-8377 |
| NPI Number | 1811685100 |
|---|---|
| Provider Enumeration Date | 04/25/2023 |
| Last Update Date | 04/25/2023 |
| Certification Date | 04/25/2023 |
| Medicare PECOS PAC ID | 4284096983 |
|---|---|
| Medicare Enrollment ID | O20230811002350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811685100 | NPI | - | NPPES |
| Provider Name | Theressia Louise Washington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992951347 PECOS PAC ID: 2668667452 Enrollment ID: I20101105000729 |
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