Individual
ELIZABETH M POLENSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
Mailing address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
CG60829222
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CG60829222
WA
Other
Enumeration date
02/06/2018
Last updated
12/14/2018
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