Individual
ALEKSANDR MARCHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14807 NE 87TH ST, VANCOUVER, WA 98682-3443
(503) 807-8211
Mailing address
14807 NE 87TH ST, VANCOUVER, WA 98682-3443
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81-4785489
—
WA
Enumeration date
12/19/2017
Last updated
12/19/2017
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