Individual
KENNETH WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2952 SW 59TH ST, OKLAHOMA CITY, OK 73119-6402
(405) 495-5154
(405) 666-7144
Mailing address
1721 SW 33RD ST, MOORE, OK 73160-2926
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MW1058912
OK
Other
Enumeration date
05/25/2007
Last updated
01/06/2009
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