Petruk, Lyudmila Ivanovna
Petruk, Lyudmila Ivanovna is an individual health care provider with primary practice located at 209 Martin Luther King Jr Way , Tacoma WA 98405-4265. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine, Sports Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Petruk, Lyudmila Ivanovna can be contacted via phone (253) 596-3410.Contact Information
Primary practice address
209 Martin Luther King Jr Way
Tacoma WA 98405-4265
Phone: (253) 596-3410
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine, Sports Medicine | 204C00000X | MD00046499 | Washington |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 4215 | Wisconsin |
| Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine, Sports Medicine | 204C00000X | MD27033 | Oregon |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 21092 | Nevada |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 76532 | Minnesota |
Profile Details
| NPI number | 1528154770 |
|---|---|
| LBN Legal business name | Petruk, Lyudmila Ivanovna |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2006 |
| Last updated | Jul 10th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528154770 | NPPES |
| Oregon | Other | MD27033 | MEDICAL LICENSE |
| Oregon | MEDICAID | 8543415 | MEDICAL LICENSE |
Popular Providers
-
Friedman, Jason
Madigan Army Medical Center 9040 Jackson Ave , Tacoma WA 98431-0001 -
Erickson, Jay C.
1608 S J St Fl 5 , Tacoma WA 98405-4930 -
Scott, Beverly Rice
9040 Jackson Ave , Tacoma WA 98431-0001 -
Iosso, Colin T
1608 S J St Fl 5 , Tacoma WA 98405-4930 -
Grazko, Marybeth Arvidson
Madigan Army Medical Center 9040 Jackson Avenue , Tacoma WA 98431 -
Ryan, Traci D
915 6Th Ave Suite 200, Tacoma WA 98405-4682 -
Mebust, Kimberly A
915 6Th Ave Suite 200, Tacoma WA 98405-4682 -
Heber, Kari K
Madigan Army Medical Center 9040 Jackson Ave, Attn: Mchj-Clq-C, Tacoma WA 98431-1100