Provider Demographics
NPI:1821219213
Name:ZHUKOVSKAYA, ZORYANA (LMT)
Entity Type:Individual
Prefix:
First Name:ZORYANA
Middle Name:
Last Name:ZHUKOVSKAYA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13501 157TH CT NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-1700
Mailing Address - Country:US
Mailing Address - Phone:206-999-0362
Mailing Address - Fax:206-241-5562
Practice Address - Street 1:3459 S 152ND ST
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2176
Practice Address - Country:US
Practice Address - Phone:206-999-0362
Practice Address - Fax:206-241-5562
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00011696225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAZH5872OtherREGENCE PROVIDER #
WA0123766OtherWORKER'S COMP
WAZH5872OtherREGENCE PROVIDER #