Individual
LEYA POLTAVSKAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4680 CORDATA PKWY, BELLINGHAM, WA 98226-8038
(360) 398-1966
Mailing address
511 FLAIR VALLEY DR, MAPLE FALLS, WA 98266-7033
(360) 922-2914
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160793208
WA
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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