VLADIMIR KUKSENKO

FERNDALE, WA
NPI1003362328
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy320700000X Residential Treatment Facility, Physical Disabilities
(Licence: WA  60525301)
Enumeration Date2016-08-28
Last Update Date2016-08-28
Business Address
Mr. VLADIMIR KUKSENKO
1958 EATON AVE
FERNDALE, WA 98248-9709
Phone number: 360-318-5636
Mailing Address
Mr. VLADIMIR KUKSENKO
1958 EATON AVE
FERNDALE, WA 98248
Phone number: 360-318-5636