Individual
DR. DIANA E. VELIKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2555 MARVIN RD NE, LACEY, WA 98516-3138
(360) 923-4600
(360) 412-2256
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(877) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00042875
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8381659
—
WA
Enumeration date
06/16/2005
Last updated
01/02/2018
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