NPIMap

Individual provider Active NPI

Tatyana A Golovach, LMP

  • Specialist
  • Lakewood, WA
National Provider Identifier
1902080435
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
23395 Issued in WA
Practice address
8909 Gravelly Lake Dr SW
Lakewood, WA 98499-3101
Phone
(253) 584-1144
Fax
(253) 588-5060
NPI assigned
Dec 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 23395 WA Primary

Addresses

Primary practice location

8909 Gravelly Lake Dr SW
Lakewood, WA 98499-3101

Mailing address

8909 Gravelly Lake Dr SW
Lakewood, WA 98499-3101
Phone (253) 584-1144

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

State licenses

LicenseStateTypeSpecialty
23395WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Medical & Chiropractic, P.S. Past Accepting new patients
Thomas J Young DC ND PS Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1902080435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8909 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993101",
            "telephone_number": "253-584-1144",
            "fax_number": "253-588-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8909 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993101",
            "telephone_number": "253-584-1144",
            "fax_number": "253-588-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOVACH",
        "first_name": "TATYANA",
        "middle_name": "A",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "23395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.