Provider Demographics
NPI:1275231193
Name:SHARKEVICH, AVIGEYA
Entity Type:Individual
Prefix:
First Name:AVIGEYA
Middle Name:
Last Name:SHARKEVICH
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 1:12324 9TH DR SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-5815
Mailing Address - Country:US
Mailing Address - Phone:425-343-8308
Mailing Address - Fax:
Practice Address - Street 1:651 STRANDER BLVD STE 105
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2914
Practice Address - Country:US
Practice Address - Phone:063-138-8402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician