Provider Demographics
NPI:1447121967
Name:WASHINGTON, BRYON LEE (DC)
Entity type:Individual
Prefix:
First Name:BRYON
Middle Name:LEE
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PEARL DR STE 1
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-1927
Mailing Address - Country:US
Mailing Address - Phone:386-677-9355
Mailing Address - Fax:
Practice Address - Street 1:4 PEARL DR STE 1
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-1927
Practice Address - Country:US
Practice Address - Phone:386-677-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14678CH111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty