MEDICARE: DANIEL KOVALENKO LMT

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	225700000X	Massage Therapist	MA60864501	WA

General Provider Information

NPI Number	:	1437001682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL KOVALENKO LMT

Provider Business Mailing Address
First Line	:	3126 S MOUNT VERNON ST APT 93
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-3525
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	122 N RAYMOND RD STE A
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-6832
Country	:	US
Telephone Number	:	509-723-6996
Fax Number	:

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

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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