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Individual

ELIZABETH P KUSTYUKOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1015 S 16TH AVE, YAKIMA, WA 98902-5316
(253) 921-1377
Mailing address
1015 S 16TH AVE, YAKIMA, WA 98902-5316
(509) 574-4917

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary

Other

Enumeration date
04/05/2025
Last updated
01/01/2026
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