Provider Demographics
NPI:1821654450
Name:ZALYASHKO, VYACHESLAV P (DENTURIST)
Entity Type:Individual
Prefix:
First Name:VYACHESLAV
Middle Name:P
Last Name:ZALYASHKO
Suffix:
Gender:M
Credentials:DENTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15506 NE 82ND CIR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-3745
Mailing Address - Country:US
Mailing Address - Phone:360-771-7776
Mailing Address - Fax:360-256-2829
Practice Address - Street 1:13720 NE 28TH ST STE B
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-8289
Practice Address - Country:US
Practice Address - Phone:360-256-4656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist