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General NPI Number Information
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NPI Number | 1730260142
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Entity Type | Organization
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Legal Business Name | WALTER REED ARMY MEDICAL CENTER
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6900 GEORGIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20307-0003
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Country | US
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Telephone | 202-782-6374
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Fax |
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Provider Business Mailing Address
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Address Line | 13222 FOXHALL DR
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City | SILVER SPRING
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State | MD
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Zip | 20906-5305
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/ US ARMY
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Name | KATHLEEN E YANCOSEK
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Credential |
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Telephone | 202-782-6374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number | OC006201L
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License Number State | PA
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