Provider Demographics
NPI:1295995645
Name:MOSKALENKO, LYUDMILA (RPH)
Entity type:Individual
Prefix:
First Name:LYUDMILA
Middle Name:
Last Name:MOSKALENKO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:LUDA
Other - Middle Name:
Other - Last Name:MOSKALENKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:16201 NE 45TH CT
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5442
Mailing Address - Country:US
Mailing Address - Phone:425-881-1220
Mailing Address - Fax:
Practice Address - Street 1:9820 NE 132ND ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-1927
Practice Address - Country:US
Practice Address - Phone:425-823-4488
Practice Address - Fax:425-821-6484
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00049041183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist