Provider Demographics
NPI:1578308508
Name:WASHAYA, TINASHE
Entity type:Individual
Prefix:
First Name:TINASHE
Middle Name:
Last Name:WASHAYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3326 GUESS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2160
Mailing Address - Country:US
Mailing Address - Phone:919-345-7704
Mailing Address - Fax:
Practice Address - Street 1:3326 GUESS RD STE 101
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2160
Practice Address - Country:US
Practice Address - Phone:919-345-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center