Healthcare Provider Details

I. General information

NPI: 1912502121
Provider Name (Legal Business Name): RUFINA ARKHIPCHUK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 QUEEN ANNE AVE N STE 204
SEATTLE WA
98109-2876
US

IV. Provider business mailing address

11201 SE 272ND PL
KENT WA
98030-9043
US

V. Phone/Fax

Practice location:
  • Phone: 253-632-0712
  • Fax:
Mailing address:
  • Phone: 253-632-0712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA61558436
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: