Individual
KETHIA SHANELLE WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10701 EAST BLVD, CLEVELAND, OH 44106-1702
(216) 791-3800
Mailing address
10701 EAST BLVD, CLEVELAND, OH 44106-1702
(216) 791-3800
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
204948
GA
363LF0000X
Family Nurse Practitioner
RN204948
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN204948
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000456486A
—
GA
Enumeration date
08/27/2012
Last updated
08/12/2025
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