Healthcare Provider Details

I. General information

NPI: 1760417307
Provider Name (Legal Business Name): CYNTHIA JEONA FOLSOME MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. CYNTHIA J WASHINGTON

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 EVERGREEN RD STE 104
GAMBRILLS MD
21054-1979
US

IV. Provider business mailing address

306 W REDWOOD ST STE 201
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 410-757-2077
  • Fax:
Mailing address:
  • Phone: 509-768-2249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101278791
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0059684
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD210012175
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: