Provider Demographics
NPI:1629759824
Name:WASCHUK, JUSTINA MELISS
Entity Type:Individual
Prefix:MS
First Name:JUSTINA
Middle Name:MELISS
Last Name:WASCHUK
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 1:16 HIAWATHA AVE
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-3214
Mailing Address - Country:US
Mailing Address - Phone:403-340-9435
Mailing Address - Fax:
Practice Address - Street 1:16 HIAWATHA AVE
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-3214
Practice Address - Country:US
Practice Address - Phone:403-340-9435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist