Provider Demographics
NPI:1902136757
Name:SENYSHYN, YULIYA (LMP)
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:SENYSHYN
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 1:1020 112TH STE W
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204
Mailing Address - Country:US
Mailing Address - Phone:206-228-0133
Mailing Address - Fax:425-338-0765
Practice Address - Street 1:1700 132ND ST SE STE L
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-5309
Practice Address - Country:US
Practice Address - Phone:425-338-1555
Practice Address - Fax:425-338-0765
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-29
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60055230174400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist