Individual
IRINA STANISLAVOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17219 NE 6TH ST, VANCOUVER, WA 98684-3780
(360) 721-6111
Mailing address
17219 NE 6TH ST, VANCOUVER, WA 98684-3780
(360) 721-6111
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NC 60237826
WA
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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