Basic Information
Provider Information
NPI: 1003150020
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WASHINGTON
FirstName: NETHERLAND
MiddleName: BETH
NamePrefix: MRS.
NameSuffix:  
Credential: DOULA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1717 PICCARD DR
Address2:  
City: ROCKVILLE
State: MD
PostalCode: 208506066
CountryCode: US
TelephoneNumber: 3018691097
FaxNumber:  
Practice Location
Address1: 1717 PICCARD DR
Address2:  
City: ROCKVILLE
State: MD
PostalCode: 208506066
CountryCode: US
TelephoneNumber: 3018691097
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/15/2012
LastUpdateDate: 11/15/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
374J00000X374J00000XMDY Nursing Service Related ProvidersDoula 

No ID Information.


Home