Provider Demographics
NPI:1609102466
Name:GERASIMCHUK, OKSANA N (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MISS
First Name:OKSANA
Middle Name:N
Last Name:GERASIMCHUK
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 NE ANDRESEN RD
Mailing Address - Street 2:D11-A
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-7347
Mailing Address - Country:US
Mailing Address - Phone:360-609-6204
Mailing Address - Fax:
Practice Address - Street 1:2700 NE ANDRESEN RD
Practice Address - Street 2:D11-A
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7347
Practice Address - Country:US
Practice Address - Phone:360-609-6204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60012019225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist