Organization
KAISER PERMANENTE ASHBURN MED CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN SWINTON (CREDENTIALING DIRECTOR)
(301) 257-2797
Entity
Organization
Contact information
Practice address
43480 YUKON DR, STE 100, ASHBURN, VA 20147-6984
(703) 227-5006
Mailing address
4000 GARDEN CITY DR, HYATTSVILLE, MD 20785-2418
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
3336M0003X
Managed Care Organization Pharmacy
Primary
0201004121
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4839669
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/11/2006
Last updated
10/10/2025
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