Provider Demographics
NPI:1861673444
Name:BREDIKHINA, YELENA YURIEVNA (ARNP)
Entity Type:Individual
Prefix:
First Name:YELENA
Middle Name:YURIEVNA
Last Name:BREDIKHINA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 MADRONE LN N
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1862
Mailing Address - Country:US
Mailing Address - Phone:206-842-2278
Mailing Address - Fax:206-842-5206
Practice Address - Street 1:147 MADRONE LN N
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1862
Practice Address - Country:US
Practice Address - Phone:206-842-2278
Practice Address - Fax:206-842-5206
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007830363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health