MEDICARE: MARILYN A WASHINGTON

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	171M00000X	Case Manager/Care Coordinator
3	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1194930586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN A WASHINGTON

Provider Business Mailing Address
First Line	:	3628 MADISON AVE STE 7
Second Line	:
City	:	NORTH HIGHLANDS
State	:	CA
Zip	:	95660-5070
Country	:	US
Telephone Number	:	916-576-4222
Fax Number	:

Provider Business Practice Location Address
First Line	:	3628 MADISON AVE STE 7
Second Line	:
City	:	NORTH HIGHLANDS
State	:	CA
Zip	:	95660-5070
Country	:	US
Telephone Number	:	916-576-4222
Fax Number	:

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

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	11/23/2022

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Directions to “ MARILYN A WASHINGTON ” Practice Location

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