Provider Demographics
NPI:1750581856
Name:GUTNYK, LILIYA (LMP)
Entity type:Individual
Prefix:MISS
First Name:LILIYA
Middle Name:
Last Name:GUTNYK
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24921 115TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-6594
Mailing Address - Country:US
Mailing Address - Phone:206-898-9060
Mailing Address - Fax:
Practice Address - Street 1:24921 115TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6594
Practice Address - Country:US
Practice Address - Phone:206-898-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018637174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist