Provider Demographics
NPI:1235432873
Name:TSVYAN, ANDREY MIKHAIL (LMP)
Entity Type:Individual
Prefix:
First Name:ANDREY
Middle Name:MIKHAIL
Last Name:TSVYAN
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30028 125TH CT SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-2153
Mailing Address - Country:US
Mailing Address - Phone:253-334-1578
Mailing Address - Fax:
Practice Address - Street 1:30028 125TH CT SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-2153
Practice Address - Country:US
Practice Address - Phone:253-334-1578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60192367225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist