Individual
MICHAEL LAWRENCE CHERNEKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1225 CAMPBELL WAY, SUITE 201, BREMERTON, WA 98310-3351
(360) 377-1355
(360) 377-1558
Mailing address
2520 CHERRY AVE, BREMERTON, WA 98310-4229
(360) 377-3911
(360) 377-1558
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003909
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
253470
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8320624
—
WA
Enumeration date
11/02/2006
Last updated
01/04/2016
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