MEDICARE: ZANAIDAH 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	335E00000X	Prosthetic/Orthotic Supplier		NC

General Provider Information

NPI Number	:	1093415895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZANAIDAH WASHINGTON

Provider Business Mailing Address
First Line	:	207 LOFT LN APT 64
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-3857
Country	:	US
Telephone Number	:	678-751-4580
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 LOST LANE UNIT 64
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7844
Country	:	US
Telephone Number	:	919-438-0867
Fax Number	:

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

Provider Enumeration Date	:	03/09/2023
Last Update Date	:	03/09/2023

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Directions to “ ZANAIDAH WASHINGTON ” Practice Location

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