Provider Demographics
NPI:1205282472
Name:STRELYUK, IRINA (NMD)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:STRELYUK
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3280 N RON LN
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-7511
Mailing Address - Country:US
Mailing Address - Phone:208-593-3059
Mailing Address - Fax:208-417-1314
Practice Address - Street 1:3280 N RON LN
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-7511
Practice Address - Country:US
Practice Address - Phone:208-593-3059
Practice Address - Fax:208-417-1314
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND995175F00000X
WANT60577343175F00000X
IDNMD-0039175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath