Provider Demographics
NPI:1457186470
Name:KOSTIUK, OLEKSANDRA
Entity type:Individual
Prefix:
First Name:OLEKSANDRA
Middle Name:
Last Name:KOSTIUK
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 1:428 SW OAK ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-3936
Mailing Address - Country:US
Mailing Address - Phone:503-577-5845
Mailing Address - Fax:
Practice Address - Street 1:428 SW OAK ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-3936
Practice Address - Country:US
Practice Address - Phone:503-577-5845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor