Individual
KATERYNA KUZMYCHOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10333 19TH AVE SE STE 109, EVERETT, WA 98208-4267
(425) 742-4600
Mailing address
PO BOX 1046, BELLEVUE, WA 98009-1046
(425) 246-9503
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
60495298
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60975323
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019028361
ANCC
MD
Enumeration date
06/06/2019
Last updated
07/30/2019
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