Provider Demographics
NPI:1033094784
Name:MALAKHOV, YURI
Entity type:Individual
Prefix:
First Name:YURI
Middle Name:
Last Name:MALAKHOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7104 190TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:LONGBRANCH
Mailing Address - State:WA
Mailing Address - Zip Code:98351-8231
Mailing Address - Country:US
Mailing Address - Phone:208-283-2619
Mailing Address - Fax:
Practice Address - Street 1:7104 190TH AVE SW
Practice Address - Street 2:
Practice Address - City:LONGBRANCH
Practice Address - State:WA
Practice Address - Zip Code:98351-8231
Practice Address - Country:US
Practice Address - Phone:208-283-2619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter