Individual
PAVEL NYUKEYEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LD
Contact information
Practice address
3916 MAIN ST # 104, VANCOUVER, WA 98663-1844
(360) 524-2004
Mailing address
3916 MAIN ST # 104, VANCOUVER, WA 98663-1844
(360) 524-2004
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN61173296
WA
Other
Enumeration date
04/29/2024
Last updated
06/20/2024
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