Maksim Vladimir Sukharev, A.A.,L.M.T.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MA 60584369 Issued in WA

Practice address

6808 220TH St SW Ste 203
Mountlake Terrace, WA 98043-2187

Phone

(425) 776-1056

NPI assigned

Oct 12, 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

Credentials

Associate of Arts

State licenses

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1154871259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8757 46TH PL W",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982753403",
            "telephone_number": "425-563-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6808 220TH ST SW STE 203",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432187",
            "telephone_number": "425-776-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKHAREV",
        "first_name": "MAKSIM",
        "middle_name": "VLADIMIR",
        "credential": "A.A.,L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MA 60584369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.