Provider Demographics
NPI:1851483499
Name:KASKO, OKSANA BORISOVNA (MASSAGE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:OKSANA
Middle Name:BORISOVNA
Last Name:KASKO
Suffix:
Gender:F
Credentials:MASSAGE PRACTITIONER
Other - Prefix:MS
Other - First Name:OKSANA
Other - Middle Name:BORISOVNA
Other - Last Name:IYERUSALIMETS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1700 132ND STREET
Mailing Address - Street 2:STE L
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012
Mailing Address - Country:US
Mailing Address - Phone:425-338-1555
Mailing Address - Fax:425-338-0765
Practice Address - Street 1:1700 132ND STREET
Practice Address - Street 2:STE L
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012
Practice Address - Country:US
Practice Address - Phone:425-338-1555
Practice Address - Fax:425-338-0765
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017779225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist