Provider Demographics
NPI:1790568319
Name:ZVEREVA, KSENIYA
Entity Type:Individual
Prefix:
First Name:KSENIYA
Middle Name:
Last Name:ZVEREVA
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 1:13349 NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2542
Mailing Address - Country:US
Mailing Address - Phone:952-465-2325
Mailing Address - Fax:
Practice Address - Street 1:3670 STONE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8004
Practice Address - Country:US
Practice Address - Phone:206-834-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath