Provider Demographics
NPI:1831076546
Name:WASHINGTON, CEDRIC ALLEN II
Entity type:Individual
Prefix:
First Name:CEDRIC
Middle Name:ALLEN
Last Name:WASHINGTON
Suffix:II
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 1:2515 46TH ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-2901
Mailing Address - Country:US
Mailing Address - Phone:234-322-6498
Mailing Address - Fax:
Practice Address - Street 1:2515 46TH ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-2901
Practice Address - Country:US
Practice Address - Phone:234-322-6498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide