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Mr. Vladimir Kuksenko
Physical Disabilities Residential Treatment Facility in Ferndale, Washington
NPI 1003362328

Vladimir Kuksenko is a Physical Disabilities Residential Treatment Facility based in Ferndale, WA. Vladimir Kuksenko practices in Ferndale, WA. The NPI Number for Vladimir Kuksenko is 1003362328 and holds a License No. 60525301 (Washington).

The current practice location address for Vladimir Kuksenko is 1958 Eaton Ave, Ferndale, WA and can be reached out via phone at 360-318-5636. You can also correspond with Vladimir Kuksenko through the mailing address at 1958 EATON AVE, FERNDALE, WA - 98248 (mailing address contact number: 360-318-5636).

Location: 1958 Eaton Ave, Ferndale, WA, 98248
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003362328
Provider Name
Vladimir Kuksenko
Credential
Provider Entity Type
Individual
Gender
Male
Address
1958 Eaton Ave, Ferndale, WA, 98248
Phone Number
360-318-5636
Fax Number
Provider Enumeration Date
08/28/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1958 Eaton Ave
City
Ferndale
State
Washington
Zip
98248-9709
Phone Number
360-318-5636
Fax Number
person
Provider Business Mailing Address Details
Address
1958 Eaton Ave
City
Ferndale
State
Washington
Zip
98248-9709
Phone Number
360-318-5636
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Physical Disabilities
Speciality
-
Taxonomy
320700000X
License No.
60525301 (Washington)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
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