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General NPI Number Information
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NPI Number | 1225879521
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Entity Type | Individual
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Provider Name | MATTHEW JIN WON STRADLEY CPHT, RPHT, LPHT
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Gender | Male
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 9715 MEDICAL CENTER DR STE 100
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City | ROCKVILLE
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State | MD
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Zip | 20850-6319
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Country | US
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Telephone | 301-424-1411
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Fax | 301-424-0232
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Provider Business Mailing Address
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Address Line | 2001 L ST NW STE 500
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City | WASHINGTON
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State | DC
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Zip | 20036-4955
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Country | US
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Telephone | 202-798-0436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 0230041785
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | PT100004273
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | T28692
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License Number State | MD
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