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General NPI Number Information
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NPI Number | 1710110820
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Entity Type | Individual
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Provider Name | ELINA CHERNYAK DO
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Gender | Female
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Dates
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Enumeration Date | 08/24/2009
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 302 5TH ST STE 3
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City | CLARKSTON
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State | WA
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Zip | 99403-1801
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Country | US
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Telephone | 509-769-2211
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Fax | 509-769-2210
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Provider Business Mailing Address
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Address Line | PO BOX 189
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City | CLARKSTON
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State | WA
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Zip | 99403-0189
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Country | US
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Telephone | 509-758-5511
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Fax | 509-758-3566
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 9521A
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 48154
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | OC-0034
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 34.010590
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | OS015088
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 9495192-1204
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License Number State | UT
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Taxonomy #7
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | OP60945031
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License Number State | WA
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