Provider Demographics
NPI:1972774776
Name:TRUMAN, LYUBOV (LMP)
Entity type:Individual
Prefix:
First Name:LYUBOV
Middle Name:
Last Name:TRUMAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 SE PARK CREST AVE STE A120
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-1303
Mailing Address - Country:US
Mailing Address - Phone:360-892-3654
Mailing Address - Fax:360-892-3692
Practice Address - Street 1:705 SE PARK CREST AVE STE A120
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-1303
Practice Address - Country:US
Practice Address - Phone:360-892-3654
Practice Address - Fax:360-892-3692
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014280174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist