Healthcare Provider Details

I. General information

NPI: 1740823525
Provider Name (Legal Business Name): ERICA DANIELLE WASHINGTON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PIER 4 BLVD
BOSTON MA
02210-2453
US

IV. Provider business mailing address

200 PIER 4 BLVD
BOSTON MA
02210-2453
US

V. Phone/Fax

Practice location:
  • Phone: 872-344-1407
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number43386
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number051.303949
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: