Provider Demographics
NPI:1881777316
Name:STETSENKO, GALINA Y (MD, MHA)
Entity type:Individual
Prefix:DR
First Name:GALINA
Middle Name:Y
Last Name:STETSENKO
Suffix:
Gender:F
Credentials:MD, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:BB1353
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6524
Mailing Address - Country:US
Mailing Address - Phone:206-430-2107
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BB1353, BOX 356524
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6524
Practice Address - Country:US
Practice Address - Phone:206-685-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00049001207N00000X
CAA123412207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology