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NPI Code Detail

MEDICARE: DR. KATIE STEPHENS WASALASKI

MEDICARE: DR. KATIE STEPHENS WASALASKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202207257VA

General Provider Information

NPI Number : 1740575364
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATIE STEPHENS WASALASKI
Provider Business Mailing Address
First Line : 5902 MOUNT EAGLE DR APT 310
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22303-2515
Country : US
Telephone Number : 703-855-3551
Fax Number :
Provider Business Practice Location Address
First Line : 5115 LEESBURG PIKE
Second Line : 1893
City : FALLS CHURCH
State : VA
Zip : 22041-3207
Country : US
Telephone Number : 703-253-0022
Fax Number : 703-253-0022
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2011
Last Update Date : 06/10/2011

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Directions to “ DR. KATIE STEPHENS WASALASKI ” Practice Location

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