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Individual

NATALIA IVANOVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACNPC-AG

Contact information

Practice address
1901 S CEDAR ST STE 101, TACOMA, WA 98405-2302
(347) 241-9325
Mailing address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(347) 241-9325

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
715501
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
AP61578561
WA

Other

Enumeration date
06/01/2016
Last updated
07/11/2024
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