Doctor Name: | TATIANA SHIYAN |
NPI Number: | 1013033588 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MA00007081 |
Business Practice Address: | 4103 Bridgeport Way W Suite C University Place, WA - 984664300 |
Business Phone Number: | 2534601824 |
Business Fax Number: | 2534601920 |
Mailing Address: | 5959 S 12th St Apt 102, TACOMA |
State: | WA |
Postal Code: | 984651901 |
Phone Number: | 2534601824 |
Fax Number: | 2534601920 |
NPI Enumeration Date: | 03/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA00007081 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |