Provider Demographics
NPI:1831990266
Name:IVASHIN, IGOR
Entity type:Individual
Prefix:
First Name:IGOR
Middle Name:
Last Name:IVASHIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6224 SPRING ST # A
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-3844
Mailing Address - Country:US
Mailing Address - Phone:425-470-1072
Mailing Address - Fax:
Practice Address - Street 1:6224 SPRING ST # A
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-3844
Practice Address - Country:US
Practice Address - Phone:425-470-1072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter