Provider Demographics
NPI:1407428097
Name:SHEPELYUK, DINA VICTOROVNA (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:VICTOROVNA
Last Name:SHEPELYUK
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 200TH ST SW STE 208
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6077
Mailing Address - Country:US
Mailing Address - Phone:360-261-3646
Mailing Address - Fax:
Practice Address - Street 1:6101 200TH ST SW STE 208
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6077
Practice Address - Country:US
Practice Address - Phone:425-775-2066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61191211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily