Provider Demographics
NPI:1720323405
Name:POLYANSKIY, VERONIKA (DPT, MS)
Entity Type:Individual
Prefix:DR
First Name:VERONIKA
Middle Name:
Last Name:POLYANSKIY
Suffix:
Gender:F
Credentials:DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24219 18TH PL W
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-9283
Mailing Address - Country:US
Mailing Address - Phone:425-999-5023
Mailing Address - Fax:425-559-7787
Practice Address - Street 1:11019 NE 135TH PL
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-5314
Practice Address - Country:US
Practice Address - Phone:425-999-5023
Practice Address - Fax:425-559-7787
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12159-24225100000X
WA60317318225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist