Provider Demographics
NPI:1194211334
Name:HRYTSYUK, IRYNA
Entity Type:Individual
Prefix:
First Name:IRYNA
Middle Name:
Last Name:HRYTSYUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5767
Mailing Address - Country:US
Mailing Address - Phone:425-318-0551
Mailing Address - Fax:
Practice Address - Street 1:319 WASHINGTON AVE S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5767
Practice Address - Country:US
Practice Address - Phone:425-318-0551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60817616224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant