Active NPI
Clarence Daniel Washington, M.D.
- Neurology Physician
- Kennewick, WA
National Provider Identifier
1912942053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- MD00014637
- Practice address
- 3730 Plaza Wa
Floor 4
Kennewick, WA 99338 - Phone
- (509) 221-6450
- Fax
- (509) 221-6230
- NPI assigned
- Jun 20, 2006
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | MD00014637 | WA | Primary |
Addresses
Primary practice location
3730 Plaza Wa
Floor 4
Kennewick, WA 99338
Mailing address
780 Swift Blvd
Suite 190
Richland, WA 99352-3524
Phone (509) 943-1880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023720 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100603000972 | WA | Practitioner - Neurology | 6002945870 | Practice locations: Kennewick, WA; Richland, WA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00014637 | WA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1912942053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "780 SWIFT BLVD",
"address_2": "SUITE 190",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993523524",
"telephone_number": "509-943-1880",
"fax_number": "509-943-3443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3730 PLAZA WA",
"address_2": "FLOOR 4",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "99338",
"telephone_number": "509-221-6450",
"fax_number": "509-221-6230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASHINGTON",
"first_name": "CLARENCE",
"middle_name": "DANIEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WA",
"license": "MD00014637",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1023720",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, WA
- Washington CVS Pharmacy LLC (CVS Pharmacy #16276)
- Washington CVS Pharmacy LLC (CVS Pharmacy #11638)
- Washington Emergency Physician Partners PLLC
- Washington Vision Therapy of Tri-Cities, PLLC (Washington Vision Therapy Center)
- Washington Visionary Eyecare PLLC (Kennewick Vision Care)
- Baylea Watkins
- Bethany Watson
- Brooks Watson II, M.D.
- Clifton Watson Jr.
- Justin Watson, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.