=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801716857
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YELENA KRAVCHISHIN RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2026
-----------------------------------------------------
Last Update Date | 07/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2748 MILTON WAY STE 205
-----------------------------------------------------
City | MILTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98354-9379
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-940-9349
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31422 115TH PL SE
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98092-5387
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN60829260
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------