Mr. Vladimir Kuksenko

Individual provider Physical Disabilities Residential Treatment Facility · NPI 1003362328

Mr. Vladimir Kuksenko is a Physical Disabilities Residential Treatment Facility in Ferndale, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in: WA
In the registry since: 2016

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Practice location Address checks out

1958 Eaton Ave
Ferndale, WA 98248-9709
Phone: (360) 318-5636

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Specialties & licences

Physical Disabilities Residential Treatment Facility (primary)	Taxonomy 320700000X · Licence 60525301 (WA)

Record details

NPI number	1003362328
Entity type	Individual (Type 1)
Gender	Male
Sole proprietor	Yes
NPI enumerated	August 28, 2016
Last updated in NPPES	August 28, 2016
Mailing address	1958 Eaton Ave, Ferndale, WA 98248