Doctor Name: | MARINA KAZULIN |
NPI Number: | 1033565825 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | AP60644787 |
Business Practice Address: | 931 S Market Blvd Chehalis, WA - 985323423 |
Business Phone Number: | 4156509570 |
Business Fax Number: | |
Mailing Address: | 931 S Market Blvd, CHEHALIS |
State: | WA |
Postal Code: | 985323423 |
Phone Number: | 4156509570 |
Fax Number: | |
NPI Enumeration Date: | 05/11/2016 |
NPI Last Update Date: | 05/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | AP60644787 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |