Tatiana Shiyan, LMT

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00007081 Issued in WA

Practice address

4103 Bridgeport Way W
Suite C
University Place, WA 98466-4300

Phone

(253) 460-1824

Fax

(253) 460-1920

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013033588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S 12TH ST APT 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651901",
            "telephone_number": "253-460-1824",
            "fax_number": "253-460-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 BRIDGEPORT WAY W",
            "address_2": "SUITE C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664300",
            "telephone_number": "253-460-1824",
            "fax_number": "253-460-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIYAN",
        "first_name": "TATIANA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00007081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "SH3212",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "51594",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Kelly Psychiatric Services LLC
• Glenda McGowen Shepard, ARNP
• Janice Shepard
• Ajainder Shergill, D.O., M.B.A
• Shifa Healthcare PLLC
• Kelcie Shorter
• Jeffrey Keith Silverberg, MPT
• Sofe Silverman, LMP
• Steven W. Simkins, LMP
• Cyntavia E Simmons, LMP

• Specialist in University Place, WA
• Providers in University Place, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.