ALEKSANDR ANATOLYEVICH KASYANCHUK NPI 1124805031

NPI Information

  • NPI: 1124805031
  • Provider Name: ALEKSANDR ANATOLYEVICH KASYANCHUK
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 320 S KITSAP BLVD
    PORT ORCHARD, WA
    ZIP 98366
  • Phone: (360) 377-3776

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NPI Details

Aleksandr Anatolyevich Kasyanchuk is a psychiatric/mental health nurse practitioner in Port Orchard, WA with 2 years of experience. Aleksandr Anatolyevich Kasyanchuk NPI is 1124805031. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

320 S KITSAP BLVD
PORT ORCHARD, WA
ZIP 98366-778
Phone: (360) 377-3776

The NPI 1124805031 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/13/2023 and was last updated on 9/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthAP61482837WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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