Individual
OLEKSANDR P STASYUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.D
Contact information
Practice address
7411 196TH ST SW, LYNNWOOD, WA 98036-5052
(425) 678-1166
Mailing address
7924 236TH ST SW APT 300, EDMONDS, WA 98026-8838
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN60612122
WA
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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