Individual provider Active NPI

Lyudmila Vakhnenko, PT, DPT

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1447411491
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60219395 Issued in WA
Practice address
1803 132ND Ave NE
Suite 2
Bellevue, WA 98005-2261
Phone
(253) 234-7656
Fax
(425) 974-7444
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017956 PA
Physical Therapist 225100000X PT60219395 WA Primary

Addresses

Primary practice location

1803 132ND Ave NE
Suite 2
Bellevue, WA 98005-2261

Mailing address

1803 132ND Ave NE
Suite 2
Bellevue, WA 98005-2261
Phone (253) 234-7656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017956PAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1447411491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 132ND AVE NE",
            "address_2": "SUITE 2",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052261",
            "telephone_number": "253-234-7656",
            "fax_number": "425-974-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 132ND AVE NE",
            "address_2": "SUITE 2",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052261",
            "telephone_number": "253-234-7656",
            "fax_number": "425-974-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAKHNENKO",
        "first_name": "LYUDMILA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017956",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60219395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.