Doctor Name: | TATIANA SADAK |
NPI Number: | 1235466517 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | AP60122579 |
Business Practice Address: | 22608 57th Ave W Mountlake Terrace, WA - 980433835 |
Business Phone Number: | 2064591158 |
Business Fax Number: | |
Mailing Address: | 20102 Cedar Valley Rd Ste 107, LYNNWOOD |
State: | WA |
Postal Code: | 980366333 |
Phone Number: | 2064591158 |
Fax Number: | |
NPI Enumeration Date: | 11/07/2009 |
NPI Last Update Date: | 05/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | AP60122579 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |