Individual
YAKOV YEZHEVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9505 NE 180TH ST, APT 201, BOTHELL, WA 98011-3367
(206) 227-7546
Mailing address
9505 NE 180TH ST, APT 201, BOTHELL, WA 98011-3367
(206) 227-7546
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
60079835
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
646584
EVERGREEN CARE NETWORK
WA
Enumeration date
11/17/2015
Last updated
11/17/2015
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