Provider Demographics
NPI:1235550856
Name:CHERNUKHIN, NIKOLAY NIKOLAEVICH JR (DC)
Entity Type:Individual
Prefix:MR
First Name:NIKOLAY
Middle Name:NIKOLAEVICH
Last Name:CHERNUKHIN
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:221-A NE 104TH AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664
Mailing Address - Country:US
Mailing Address - Phone:360-737-9665
Mailing Address - Fax:360-737-9634
Practice Address - Street 1:221-A NE 104TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664
Practice Address - Country:US
Practice Address - Phone:360-737-9665
Practice Address - Fax:360-737-9634
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WACH60421741111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor