Active NPI
Tatjana Damnjanovic, PHD
- Forensic Psychologist
- Tacoma, WA
National Provider Identifier
1538807490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- PY61110289
- Practice address
- 1115 Tacoma Ave S
Tacoma, WA 98402-2005 - Phone
- (253) 237-3456
- NPI assigned
- May 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY61110289 | WA | |
| Forensic Psychologist | 103TF0200X | PY61110289 | WA | Primary |
Addresses
Primary practice location
1115 Tacoma Ave S
Tacoma, WA 98402-2005
Mailing address
PO Box 316
Milton, WA 98354-0316
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY61110289 | WA | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653091200000",
"number": "1538807490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 316",
"city": "MILTON",
"state": "WA",
"postal_code": "983540316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 TACOMA AVE S",
"city": "TACOMA",
"state": "WA",
"postal_code": "984022005",
"telephone_number": "253-237-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMNJANOVIC",
"first_name": "TATJANA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-21",
"last_updated": "2022-05-21",
"certification_date": "2022-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY61110289",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "WA",
"license": "PY61110289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.