MARIYA KHOMLYAK (NPI# 1164820668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164820668 |
| Entity Type | Individual |
| Full Name | MARIYA KHOMLYAK |
| Credential | NAR |
| Practice Address |
2111 Shattuck Pl S Renton WA 98055-4289 |
| Practice Telephone | 4252770452 |
| Practice Fax Number | 4252711107 |
| Mailing Telephone | 4252770452 |
| Mailing Fax Number | 4252711107 |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2014-12-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | 750970 | WA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | SOCIAL SERVICE PAYMENT SYSTEM NUMBER | 156016 | 01 |
| Street Address |
2111 SHATTUCK PL S |
| City | RENTON |
| State | WA |
| Zip Code | 98055-4289 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366799660 | Constance Ruth Grace | Contractor | 16921 135th Pl Se, Renton, WA 98058-6901 | 2012-08-07 |
| 1912282500 | Anna Marie Koonce | Contractor | 10622 Se Carr Rd # A, Renton, WA 98055-5406 | 2011-10-14 |
| 1073823936 | Katherine Jones | Contractor | 912 N 1rst St, Renton, WA 98057-5759 | 2010-10-13 |
| 1568772556 | Patrick N Okoye | Contractor | 612 Nw 3rd Ct, Renton, WA 98057-3400 | 2010-10-08 |
| 1730308024 | Deborah J. Smith | Contractor | 4300 Talbot Rd S Ste 304, Renton, WA 98055-6238 | 2007-04-24 |
| 1194190538 | Massage for World Peace | Contractor | 17333 Se 133rd St, Renton, WA 98059-7026 | 2015-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376158410 | Luan Kim Do | Contractor | 1832 Pointe Woodworth Dr Ne, Tacoma, WA 98422-3466 | 2020-09-15 |
| 1023635026 | Vanessa L Mendez | Contractor | 4306 Vermilion Ln, Pasco, WA 99301-1321 | 2020-06-25 |
| 1144844150 | Michele Burtner | Contractor | 36 Salvaggi Ln, Elma, WA 98541-9063 | 2020-06-04 |
| 1760017495 | Estefani Perete Gomez | Contractor | 606 Lilly Rd Ne Apt 324, Olympia, WA 98506-5169 | 2020-03-03 |
| 1073144424 | Strom Holdings LLC | Contractor | 3335 Paine Ave, Everett, WA 98201-5301 | 2020-02-03 |
| 1528602182 | Deborah Harris | Contractor | 1284 Mt Baker Ave, Camano Island, WA 98282-8439 | 2019-11-06 |
| 1205486826 | Hattie Marie Stigum | Contractor | 2406 Ne 139th St Apt 298, Vancouver, WA 98686-2314 | 2019-09-16 |
| 1134774425 | Amanda Rene Collins | Contractor | 11905 N Guinevere Dr, Spokane, WA 99218-1715 | 2019-08-05 |
| 1720566755 | American Integrated Health | Contractor | 14121 Tukla Intl Blvd, Tukwila, WA 98168-4122 | 2018-08-01 |
| 1093202053 | Wilson Pershing Stevenson IIi | Contractor | 3250 Port of Benton Blvd Ste D, Richland, WA 99354-1670 | 2018-04-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.