Provider Demographics
NPI:1255598215
Name:PALAMARYUK, LYUDMILA V
Entity type:Individual
Prefix:
First Name:LYUDMILA
Middle Name:V
Last Name:PALAMARYUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9211 NE180TH WAY
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-5290
Mailing Address - Country:US
Mailing Address - Phone:360-253-9010
Mailing Address - Fax:360-576-5355
Practice Address - Street 1:9211 NE 180TH WAY
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-5290
Practice Address - Country:US
Practice Address - Phone:360-253-9010
Practice Address - Fax:360-576-5355
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA698400311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home