KONSTANTIN IVANOVICH IVANCHENKO (NPI# 1306064068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306064068 |
| Entity Type | Individual |
| Full Name | KONSTANTIN IVANOVICH IVANCHENKO |
| Credential | LMP |
| Practice Address |
802 Central Ave S Kent WA 98032-6107 |
| Mailing Address |
422 Homer Ave Pacific WA 98047-1454 |
| Practice Telephone | 2538592940 |
| Mailing Telephone | 2538045725 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA00017970 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
802 CENTRAL AVE S |
| City | KENT |
| State | WA |
| Zip Code | 98032-6107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952460305 | Dr. Romero P.s., Inc. | Chiropractor | 802 Central Ave S, Kent, WA 98032-6107 | 2006-12-08 |
| 1689888513 | Victor Vysotsky | Massage Therapist | 802 Central Ave S, Kent, WA 98032-6107 | 2007-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952866790 | Cornerstone Ocd Anxiety | Counselor | 415 Railroad Ave S, Kent, WA 98032 | 2019-02-06 |
| 1861962458 | Mohamed Osman Awad | Counselor | 124 4th Ave S Suite 230, Kent, WA 98032 | 2018-11-27 |
| 1649747387 | Hannah Grace Rosborough | Counselor | 19435 68th Ave S Bldg S Ste 109, Kent, WA 98032 | 2018-10-31 |
| 1063948164 | Teasya Kusumo | Marriage & Family Therapist | 232 2nd Avenue S., Suite 201, Kent, WA 98032 | 2017-05-10 |
| 1902331648 | Heather Kunce | Marriage & Family Therapist | 232 Second Ave S, Ste 201, Kent, WA 98032 | 2017-05-01 |
| 1043761489 | Julia Kocian | Social Worker | 1601 W Meeker St., #201, Sea Mar Kent Behavioral Health, Kent, WA 98032 | 2016-10-20 |
| 1760938518 | Phoeun Sath | Community Health Worker | 24328 Pacific Hwy, Kent, WA 98032 | 2016-08-31 |
| 1891241568 | Live Well Alliance, LLC | Counselor | 1103 W. Meeker Street #102, Kent, WA 98032 | 2016-08-31 |
| 1760938070 | Seattle Cpap | Durable Medical Equipment & Medical Supplies | 25329 74th Ave S, Kent, WA 98032 | 2016-08-28 |
| 1750736401 | William Dale | Technician, Other | 6302 S 238th Pl, Apt U205, Kent, WA 98032 | 2016-05-02 |
| Find all providers in zip 98032 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609421635 | Sabrina Michelle Jones | Massage Therapist | 25022 104th Ave Se Ste E, Kent, WA 98030-2822 | 2019-08-06 |
| 1124686621 | Shannon Strong | Massage Therapist | 64 Maple St Ste 1, Kent, CT 06757-1721 | 2019-05-31 |
| 1184180135 | Olesya Tkachyshyn | Massage Therapist | 11738 Se 264th St, Kent, WA 98030-8467 | 2019-02-14 |
| 1033683529 | William Kelly Blackburn | Massage Therapist | 24620 Russell Rd Apt D102, Kent, WA 98032-4745 | 2019-01-17 |
| 1811460306 | Alla Yakobchuk | Massage Therapist | 11108 Se 264th Pl, Kent, WA 98030-9032 | 2019-01-07 |
| 1821560798 | Jeanmarie Meier | Massage Therapist | 12505 Se 275th Pl, Kent, WA 98030-8523 | 2018-12-17 |
| 1932681921 | Johana Sanchez-vidales | Massage Therapist | 24837 104th Ave Se #100, Kent, WA 98030 | 2018-09-05 |
| 1952809543 | Sarah Rose Collins | Massage Therapist | 13003 Se Kent Kangley Rd Ste 110, Kent, WA 98030 | 2018-01-29 |
| 1295233328 | Tommy Eugene Sauget | Massage Therapist | 29020 188th Ave Se, Kent, WA 98042-9223 | 2018-01-23 |
| 1710408968 | Celyna Dayanara Easley | Massage Therapist | 27020 Pacific Hwy S Ste B, Kent, WA 98032-6951 | 2017-06-28 |
| Find all providers in KENT | ||||
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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.