Provider Demographics
NPI:1346945326
Name:SALAMAKHA, TETIANA
Entity Type:Individual
Prefix:
First Name:TETIANA
Middle Name:
Last Name:SALAMAKHA
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 1:6944 ANTHEM ST E
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-3805
Mailing Address - Country:US
Mailing Address - Phone:206-393-2533
Mailing Address - Fax:
Practice Address - Street 1:900 MERIDIAN E
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WA
Practice Address - Zip Code:98354-7001
Practice Address - Country:US
Practice Address - Phone:253-952-2680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA61010697183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician