Individual
TATYANA GUDISHVILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
22300 NE 58TH ST, VANCOUVER, WA 98682-9046
(360) 852-3884
(360) 558-7996
Mailing address
22300 NE 58TH ST, VANCOUVER, WA 98682-9046
(360) 852-3884
(360) 558-7996
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00149858
WA
311ZA0620X
Adult Care Home Facility
Primary
754775
WA
Other
Enumeration date
05/03/2022
Last updated
05/25/2022
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