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General NPI Number Information
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NPI Number | 1780593566
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Entity Type | Individual
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Provider Name | IRODA YASSAWY LC
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Gender | Female
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Dates
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Enumeration Date | 09/05/2026
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Last Update Date | 09/05/2026
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Provider Practice Location Address
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Address Line | 4320 SEMINARY RD
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1535
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Country | US
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Telephone | 703-504-7864
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Fax |
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Provider Business Mailing Address
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Address Line | 17980 SWANS CREEK LN
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City | DUMFRIES
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State | VA
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Zip | 22026-4526
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Country | US
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Telephone | 703-597-5786
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-311019
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License Number State | VA
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