Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. VLADIMIR KUKSENKO
Active Sole ProprietorPhysical Disabilities Residential Treatment Facility · FERNDALE, WA
Registration Details
- NPI Number
- 1003362328
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 28, 2016 (9.6489118145796 yrs)
- Last Updated
- Aug 28, 2016
- License
-
60525301 (WA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1958 EATON AVEFERNDALE, WA, 982489709Browse WA providers · Browse ZIP 98248
- Phone
- 3603185636
- Primary Specialty
-
Physical Disabilities Residential Treatment Facility
320700000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.