MEDICARE: IRINA DUKHON P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT00008554	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255482030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRINA DUKHON P.T.

Provider Business Mailing Address
First Line	:	11502 19TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-5165
Country	:	US
Telephone Number	:	206-909-8918
Fax Number	:

Provider Business Practice Location Address
First Line	:	11502 19TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-5165
Country	:	US
Telephone Number	:	206-909-8918
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	09/30/2009

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