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Individual

KENNETTA WASHINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3000 UNITED FOUNDERS BLVD STE 239, OKLAHOMA CITY, OK 73112-4294
(405) 840-7040
Mailing address
3000 UNITED FOUNDERS BLVD STE 239, OKLAHOMA CITY, OK 73112-4294
(405) 840-7040

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100741770A
OK
Enumeration date
05/07/2015
Last updated
05/07/2015
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