Provider Demographics
NPI:1447818968
Name:GOLUB, YURIY YURIYEVICH (DO)
Entity type:Individual
Prefix:
First Name:YURIY
Middle Name:YURIYEVICH
Last Name:GOLUB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 TALBOT RD S STE 401
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5738
Mailing Address - Country:US
Mailing Address - Phone:425-690-3445
Mailing Address - Fax:425-690-9445
Practice Address - Street 1:3915 TALBOT RD S STE 401
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5738
Practice Address - Country:US
Practice Address - Phone:425-690-3445
Practice Address - Fax:425-690-9445
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61172441207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine