Provider Demographics
NPI:1598987190
Name:DROZHZHIN, VERA G
Entity Type:Individual
Prefix:MRS
First Name:VERA
Middle Name:G
Last Name:DROZHZHIN
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 1:13713 10 AVE E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445
Mailing Address - Country:US
Mailing Address - Phone:253-318-5853
Mailing Address - Fax:253-538-1759
Practice Address - Street 1:13713 10TH AVE E
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445-2851
Practice Address - Country:US
Practice Address - Phone:253-318-5853
Practice Address - Fax:253-538-1759
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016324225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist