Individual
TATYANA A GOLOVACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
8909 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-3101
(253) 584-1144
(253) 588-5060
Mailing address
8909 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-3101
(253) 584-1144
(253) 588-5060
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23395
WA
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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