MEDICARE: MICHAEL WASHINGTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1437430063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL WASHINGTON

Provider Business Mailing Address
First Line	:	12427 SAINT ANDREWS DR # DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8613
Country	:	US
Telephone Number	:	405-919-3403
Fax Number	:

Provider Business Practice Location Address
First Line	:	12427 SAINT ANDREWS DR APT A
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8613
Country	:	US
Telephone Number	:	405-919-3403
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	09/09/2011

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Directions to “ MICHAEL WASHINGTON ” Practice Location

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