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General NPI Number Information
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NPI Number | 1619000247
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Entity Type | Individual
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Provider Name | VICTOR R PLAVSKY LD
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 24610 36TH AVE S
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City | KENT
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State | WA
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Zip | 98032-1520
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Country | US
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Telephone | 253-941-5400
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Fax | 866-297-7419
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Provider Business Mailing Address
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Address Line | PO BOX 58
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City | SNOQUALMIE
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State | WA
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Zip | 98065-0058
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Country | US
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Telephone | 253-941-5400
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Fax | 866-297-4193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122400000X
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Taxonomy Name | Denturist
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License Number | DN00000296
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License Number State | WA
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