Basic Information
| Provider Information | |||||||||
| NPI: | 1134370331 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KLIMOVA NESCOT | ||||||||
| FirstName: | IRINA | ||||||||
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| Credential: | M.S., PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 17TH AVE | ||||||||
| Address2: | STE 500 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981225788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063202800 | ||||||||
| FaxNumber: | 2063202827 | ||||||||
| Practice Location | |||||||||
| Address1: | 550 17TH AVE | ||||||||
| Address2: | STE 500 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981225788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063202800 | ||||||||
| FaxNumber: | 2063202827 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2008 | ||||||||
| LastUpdateDate: | 08/27/2016 | ||||||||
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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 | 363A00000X | 60672600 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.