MEDICARE: DR. GALINA Y STETSENKO MD, MHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	MD00049001	WA
2	207N00000X	Dermatology Physician	A123412	CA

General Provider Information

NPI Number	:	1881777316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GALINA Y STETSENKO MD, MHA

Provider Business Mailing Address
First Line	:	1959 NE PACIFIC ST
Second Line	:	BB1353
City	:	SEATTLE
State	:	WA
Zip	:	98195-6524
Country	:	US
Telephone Number	:	206-430-2107
Fax Number	:

Provider Business Practice Location Address
First Line	:	1959 NE PACIFIC ST
Second Line	:	BB1353, BOX 356524
City	:	SEATTLE
State	:	WA
Zip	:	98195-6524
Country	:	US
Telephone Number	:	206-685-6120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	01/08/2013

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