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General NPI Number Information
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NPI Number | 1083090609
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Entity Type | Individual
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Provider Name | PHILLIP WASHINGTON SR.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 5025 NELLIS OASIS LN APT 244
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City | LAS VEGAS
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State | NV
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Zip | 89115-0770
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Country | US
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Telephone | 714-499-6232
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Fax |
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Provider Business Mailing Address
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Address Line | 5025 NELLIS OASIS LN APT 244
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City | LAS VEGAS
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State | NV
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Zip | 89115-0770
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Country | US
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Telephone | 714-499-6232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 26-0-086-469
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | CHW1-6167
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License Number State | NV
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