Basic Information
| Provider Information | |||||||||
| NPI: | 1902066228 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAJENOVA | ||||||||
| FirstName: | NATALIA | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | GALKINA | ||||||||
| OtherFirstName: | NATALIA | ||||||||
| OtherMiddleName: | V | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 903 MEDICAL CENTER DRIVE | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604358595 | ||||||||
| FaxNumber: | 3604355233 | ||||||||
| Practice Location | |||||||||
| Address1: | 903 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604358595 | ||||||||
| FaxNumber: | 3604355233 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2008 | ||||||||
| LastUpdateDate: | 08/06/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207W00000X | MD60274788 | WA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.