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General NPI Number Information
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NPI Number | 1871229047
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Entity Type | Individual
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Provider Name | OKSANA NESTERENKO MD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2022
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 3020 S UNION AVE
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City | TACOMA
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State | WA
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Zip | 98409-3317
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Country | US
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Telephone | 253-844-4327
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Fax |
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Provider Business Mailing Address
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Address Line | 917 PACIFIC AVE STE 600
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City | TACOMA
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State | WA
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Zip | 98402-4437
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Country | US
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Telephone | 253-844-4327
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MDCE.ML.61331468
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License Number State | WA
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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 | MDCE.ML.61331468
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License Number State | WA
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