Individual
TATYANA IVANOVNA MOLCHANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
505 NE 87TH AVE STE 301, VANCOUVER, WA 98664-1965
(360) 514-7060
(360) 514-7068
Mailing address
5306 NE 54TH AVE, VANCOUVER, WA 98661-2197
(503) 919-5812
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00175960
WA
363LF0000X
Family Nurse Practitioner
Primary
AP61140896
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123123
N/A
WA
05
—
123123
—
WA
Enumeration date
05/06/2019
Last updated
09/30/2024
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