Organization
KEYA HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SEBLE WONGEL DEJENE (PRESIDENT)
(703) 261-7001
Entity
Organization
Contact information
Practice address
1801 ROBERT FULTON DR STE 480, RESTON, VA 20191-5481
(703) 261-7000
(708) 860-1040
Mailing address
1801 ROBERT FULTON DR STE 480, RESTON, VA 20191-5481
(703) 261-7000
(708) 860-1040
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
302R00000X
Health Maintenance Organization
—
—
305R00000X
Preferred Provider Organization
—
—
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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