Vladimir Kuksenko

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

60525301 Issued in WA

Practice address

1958 Eaton Ave
Ferndale, WA 98248-9709

Phone

(360) 318-5636

NPI assigned

Aug 28, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1003362328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1958 EATON AVE",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "98248",
            "telephone_number": "360-318-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1958 EATON AVE",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982489709",
            "telephone_number": "360-318-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKSENKO",
        "first_name": "VLADIMIR",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "WA",
            "license": "60525301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyrylo Kirieiev, LCPO
• John R. Knudsen, M.D.
• Pawel Kojs, PHARMD
• Susan E Kranzpiller, MD
• Kathryn Mary Kraynak, PT, C/NDT
• Laboratory Corporation of America
• Kevin Van Lai, PHARMD
• Janice Lapsansky
• Karen Beth Larson, OTR/L
• Jacque Larue, LMT

• Physical Disabilities Residential Treatment Facility in Ferndale, WA
• Providers in Ferndale, WA by specialty
• Physical Disabilities Residential Treatment Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.