Provider Demographics
NPI:1891550125
Name:SKOROMNAYA, YELIZAVETA (DC)
Entity Type:Individual
Prefix:
First Name:YELIZAVETA
Middle Name:
Last Name:SKOROMNAYA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 W TUCANNON AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7213
Mailing Address - Country:US
Mailing Address - Phone:509-579-5999
Mailing Address - Fax:509-834-7407
Practice Address - Street 1:8901 W TUCANNON AVE STE 160
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7213
Practice Address - Country:US
Practice Address - Phone:509-579-5999
Practice Address - Fax:509-834-7407
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61509406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor