MEDICARE: JILL 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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1871425793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL WASHINGTON

Provider Business Mailing Address
First Line	:	538 GARDEN VIEW CT
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30046-3184
Country	:	US
Telephone Number	:	321-332-3882
Fax Number	:

Provider Business Practice Location Address
First Line	:	2305 KILLEARN CENTER BLVD APT E101
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-3526
Country	:	US
Telephone Number	:	321-332-3882
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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