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General NPI Number Information
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NPI Number | 1891557948
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Entity Type | Individual
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Provider Name | LENA WASIELEWSKI
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Gender | Female
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 1300 CHAIN BRIDGE RD
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City | MC LEAN
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State | VA
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Zip | 22101-3935
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Country | US
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Telephone | 703-261-9585
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Fax |
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Provider Business Mailing Address
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Address Line | 1747 TYSONS CENTRAL ST APT 2905
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City | VIENNA
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State | VA
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Zip | 22182-6062
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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 |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110009808
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License Number State | VA
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