Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN60457526 | WA |
NPI | 1649712324 |
---|---|
Provider Name | Dr. Natalia Lukashova |
First Address | Lynnwood, WA 98036-7884 |
Second Address | Lynnwood, WA 98036-7884 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2016 |
Last Update Date | 10/11/2016 |