Individual
KSENIA POPOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1919 112TH ST SW, EVERETT, WA 98204-3784
(425) 513-1600
Mailing address
4301 136TH ST SE, MILL CREEK, WA 98012-8938
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC 60186882
WA
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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