Provider Demographics
NPI:1235303637
Name:TERLETSKA, NELYA S
Entity Type:Individual
Prefix:MISS
First Name:NELYA
Middle Name:S
Last Name:TERLETSKA
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 1:325 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ALGONA
Mailing Address - State:WA
Mailing Address - Zip Code:98001-4421
Mailing Address - Country:US
Mailing Address - Phone:253-887-9760
Mailing Address - Fax:253-887-8310
Practice Address - Street 1:325 5TH AVE N
Practice Address - Street 2:
Practice Address - City:ALGONA
Practice Address - State:WA
Practice Address - Zip Code:98001-4421
Practice Address - Country:US
Practice Address - Phone:253-887-9760
Practice Address - Fax:253-887-8310
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home