Individual
GANNA IEVTUSHENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28940 229TH PL SE, BLACK DIAMOND, WA 98010-1250
(425) 233-1611
Mailing address
28940 229TH PL SE, BLACK DIAMOND, WA 98010-1250
(425) 233-1611
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NC61678085
WA
Other
Enumeration date
05/09/2025
Last updated
05/09/2025
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