NPI 1003362328

Vladimir Kuksenko

Practitioner Physical Disabilities Residential Treatment Facility Ferndale, WA

Practice location

Address: 1958 Eaton Ave, Ferndale, WA 98248-9709
Phone: (360) 318-5636
Mailing address: 1958 Eaton Ave, Ferndale, WA 98248

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence 60525301 (WA)

Other Residential Treatment Facility, Physical Disabilities providers in Washington →

Registry record

NPI: 1003362328
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Aug 2016
Record last updated: 28 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.