Provider Demographics
NPI:1982301909
Name:ARKHIPCHUK, YEVGENIYA (PTA)
Entity type:Individual
Prefix:
First Name:YEVGENIYA
Middle Name:
Last Name:ARKHIPCHUK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12309 22ND ST NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-9500
Mailing Address - Country:US
Mailing Address - Phone:425-335-1500
Mailing Address - Fax:
Practice Address - Street 1:12806 20TH ST NE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-9243
Practice Address - Country:US
Practice Address - Phone:425-737-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA161037086225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant