Provider Demographics
NPI:1346800125
Name:TSVAN, SOLOMIYA
Entity Type:Individual
Prefix:
First Name:SOLOMIYA
Middle Name:
Last Name:TSVAN
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 1:14882 SE 279TH PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4371
Mailing Address - Country:US
Mailing Address - Phone:206-816-0172
Mailing Address - Fax:
Practice Address - Street 1:7102 S 220TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-1946
Practice Address - Country:US
Practice Address - Phone:253-478-4910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60882509183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist