Provider Demographics
NPI:1215774138
Name:DATSKIY, SERGEY AMOSOVICH (DPT)
Entity type:Individual
Prefix:DR
First Name:SERGEY
Middle Name:AMOSOVICH
Last Name:DATSKIY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4637
Mailing Address - Country:US
Mailing Address - Phone:360-714-0870
Mailing Address - Fax:
Practice Address - Street 1:420 OHIO ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4637
Practice Address - Country:US
Practice Address - Phone:360-714-0870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT.PT.61563929225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist