Individual
DR. PAVLO BOHDAN GUSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10221 198TH ST E STE A100, GRAHAM, WA 98338-8038
(253) 875-2900
Mailing address
2102 83RD AVE E, EDGEWOOD, WA 98371-3747
(206) 794-8557
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE61089052
WA
1223G0001X
General Practice Dentistry
Primary
DE61089052
WA
Other
Enumeration date
12/30/2020
Last updated
06/08/2024
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