Doctor Name: | MR. VIKTOR F KLEYONKIN |
NPI Number: | 1023337854 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.P. |
License Number: | MA00022090 |
Business Practice Address: | 1803 Ne 125th Ct Vancouver, WA - 986845545 |
Business Phone Number: | 3609446895 |
Business Fax Number: | |
Mailing Address: | 1803 Ne 125th Ct, VANCOUVER |
State: | WA |
Postal Code: | 986845545 |
Phone Number: | 3609446895 |
Fax Number: | |
NPI Enumeration Date: | 05/18/2010 |
NPI Last Update Date: | 05/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA00022090 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |