Healthcare Provider Details

I. General information

NPI: 1285544502
Provider Name (Legal Business Name): WASHINGTON PROFESSIONAL MEDICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26124 PACIFIC HWY S
KENT WA
98032-6910
US

IV. Provider business mailing address

304 WAINWRIGHT DR STE 120
NORTHBROOK IL
60062-1919
US

V. Phone/Fax

Practice location:
  • Phone: 253-236-7757
  • Fax:
Mailing address:
  • Phone: 847-257-1244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: YAN KATSNELSON
Title or Position: CRED MGR
Credential: MD
Phone: 847-774-5300