Provider Demographics
NPI:1003209859
Name:BONDARENKO, OKSANA I
Entity Type:Individual
Prefix:MRS
First Name:OKSANA
Middle Name:I
Last Name:BONDARENKO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:OKSANA
Other - Middle Name:I
Other - Last Name:BONDARENKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:13518 NE 1ST PL
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-2818
Mailing Address - Country:US
Mailing Address - Phone:360-607-4894
Mailing Address - Fax:
Practice Address - Street 1:13518 NE 1ST PL
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2818
Practice Address - Country:US
Practice Address - Phone:360-607-4894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-17
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA000181888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor