Individual
VITALIY BEREZHNOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
834 SHERIDAN ST, PORT TOWNSEND, WA 98368-2443
(360) 385-2200
(360) 344-0411
Mailing address
20123 SUNNYSIDE DR N APT D301, SHORELINE, WA 98133-2749
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA60115672
WA
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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