Provider Demographics
NPI:1225879521
Name:STRADLEY, MATTHEW JIN WON (CPHT, RPHT, LPHT)
Entity type:Individual
Prefix:
First Name:MATTHEW JIN
Middle Name:WON
Last Name:STRADLEY
Suffix:
Gender:
Credentials:CPHT, RPHT, LPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 L ST NW STE 500
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-4955
Mailing Address - Country:US
Mailing Address - Phone:202-798-0436
Mailing Address - Fax:
Practice Address - Street 1:9715 MEDICAL CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6319
Practice Address - Country:US
Practice Address - Phone:301-424-1411
Practice Address - Fax:301-424-0232
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230041785183700000X
DCPT100004273183700000X
MDT28692183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician