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