Provider Demographics
NPI:1598900987
Name:SLIWINSKI, BOGUSLAWA JADWIGA
Entity Type:Individual
Prefix:
First Name:BOGUSLAWA
Middle Name:JADWIGA
Last Name:SLIWINSKI
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 1:2501 BOMBING RANGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99353-9164
Mailing Address - Country:US
Mailing Address - Phone:509-967-2454
Mailing Address - Fax:
Practice Address - Street 1:1109 MEADE AVE
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350-1366
Practice Address - Country:US
Practice Address - Phone:509-786-6658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP160042850225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant