Provider Demographics
NPI:1619606308
Name:CRESSWELL, ASHLEIGH CLAIRE (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:CLAIRE
Last Name:CRESSWELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 WILLIAMS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4618
Mailing Address - Country:US
Mailing Address - Phone:571-350-8400
Mailing Address - Fax:703-940-8697
Practice Address - Street 1:277 S WASHINGTON ST STE 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3678
Practice Address - Country:US
Practice Address - Phone:571-366-5792
Practice Address - Fax:571-366-5793
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110008483363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1619606308Medicaid
DC2I5581OtherMEDICARE PTAN