Individual
YELENA KRAVCHENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
511 WAYNE COURT SE, PACIFIC, WA 98047
(425) 563-4460
Mailing address
511 WAYNE COURT SE, PACIFIC, WA 98047
(425) 563-4460
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160827701
WA
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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