Individual
ALEKSANDR ANATOLYEVICH KASYANCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 S KITSAP BLVD, PORT ORCHARD, WA 98366-3778
(360) 377-3776
Mailing address
14134 110TH AVE NE, KIRKLAND, WA 98034-4480
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61482837
WA
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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