Individual
MR. DENNIS Y PAVLENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
216 W MAIN ST, GOLDENDALE, WA 98620-9587
(509) 773-5633
(509) 773-5844
Mailing address
216 W MAIN ST, GOLDENDALE, WA 98620-9587
(509) 773-5633
(509) 773-5844
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
61042110
WA
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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