Provider Demographics
NPI:1184378366
Name:MOVCHAN, YEKATERINA (CPHT)
Entity type:Individual
Prefix:
First Name:YEKATERINA
Middle Name:
Last Name:MOVCHAN
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 HARDESON RD UNIT 123
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-6267
Mailing Address - Country:US
Mailing Address - Phone:425-319-4996
Mailing Address - Fax:
Practice Address - Street 1:18906 US 2
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1415
Practice Address - Country:US
Practice Address - Phone:360-794-0943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA61096769183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician