Tatyana V Bakhtinova, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

17191 Bothell Way NE
Lake Forest Park, WA 98155-5534

Phone

(206) 364-8272

NPI assigned

Jul 1, 2006

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: tatyana.bakhtinova.p1@direct.pgsklallamtribe.nextgenshare.com

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1710916846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17191 BOTHELL WAY NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981555534",
            "telephone_number": "206-363-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17191 BOTHELL WAY NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981555534",
            "telephone_number": "206-364-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKHTINOVA",
        "first_name": "TATYANA",
        "middle_name": "V",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "GAB25977",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8473597",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Anthony, MA, LMHCA
• David Douglas Asmussen, D.O.
• Khushnoor Singh Aulck, PHARM.D.
• Aurelie Trier Counseling PLLC
• Ngocrine Nhan Ayvazov, LMFT
• Balance Construction, Inc.
• Being Human Therapy PLLC
• Michael Bell, PHARMD
• Eva Blum
• Thomas Boyce, MD

• Physician Assistant in Lake Forest Park, WA
• Providers in Lake Forest Park, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.