Provider Demographics
NPI:1447411491
Name:VAKHNENKO, LYUDMILA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LYUDMILA
Middle Name:
Last Name:VAKHNENKO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 132ND AVE NE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2261
Mailing Address - Country:US
Mailing Address - Phone:253-234-7656
Mailing Address - Fax:425-974-7444
Practice Address - Street 1:1803 132ND AVE NE
Practice Address - Street 2:SUITE 2
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2261
Practice Address - Country:US
Practice Address - Phone:253-234-7656
Practice Address - Fax:425-974-7444
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017956225100000X
WAPT60219395225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist