Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 11512 | MD |
NPI | 1003043563 |
---|---|
Provider Name | Paul J Washo |
First Address | Salisbury, MD 21804-4470 |
Second Address | Easton, MD 21601-7124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2009 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
259147-000 | MAGELLAN BEHAVIORAL HEALTH (01) | MD |
346646 | MHN/TRICARE (01) | MD |
609550002 | (05) | MD |
7840093 | AETNA (01) | MD |
R968 | CAREFIRST BCBS (01) | MD |