NPI 1124165329

Alexander V Koryachek, LMT

Practitioner Massage Therapist Shoreline, WA

Practice location

Address: 1207 N 200th St St.102, Shoreline, WA 98133-3213
Phone: (425) 232-7613

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MA00018914 (WA)

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Registry record

NPI: 1124165329
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Jan 2007
Record last updated: 8 Jul 2007

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.