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Individual

MR. WAYNE ANTHONY WASHINGTON II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1524 MORGAN AVE N, MINNEAPOLIS, MN 55414
(612) 200-6233
Mailing address
1524 MORGAN AVE N, MINNEAPOLIS, MN 55411-3014
(612) 200-6233

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
MN

Other

Enumeration date
11/28/2012
Last updated
11/28/2012
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