Provider Demographics
NPI:1154706729
Name:DRONOVA, INNA
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:DRONOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 LINCOLN WAY APT D207
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-5666
Mailing Address - Country:US
Mailing Address - Phone:425-345-2834
Mailing Address - Fax:
Practice Address - Street 1:2721 LINCOLN WAY APT D207
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-5666
Practice Address - Country:US
Practice Address - Phone:425-345-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60494042225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist