IndividualActive
Vladimir Kuksenko
NPI 1003362328 · Physical Disabilities Residential Treatment Facility · Ferndale, WA
Provider details
- NPI number
- 1003362328
- Entity type
- Individual
- Primary specialty
- Physical Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
- License
- 60525301 (WA)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
1958 Eaton Ave
Ferndale, WA 98248-9709
Phone: (360) 318-5636
Approximate (ZIP-level) locationGet directions
Mailing address
1958 Eaton Ave
Ferndale, WA 98248
Registry dates
- Enumerated
- 2016-08-28
- Last updated
- 2016-08-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.