Individual provider · Type 1 NPI

Tatyana Gudishvili, RN

Adult Care Home Facility · Vancouver, WA

NPI number 1407591472 Active

Practice location

22300 NE 58th St
Vancouver, WA 98682-9046

Call (360) 852-3884 Map

Fax (360) 558-7996

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000XRN00149858 (WA)
Adult Care Home Facility Primary 311ZA0620X754775 (WA)

Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

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About NPI 1407591472

Tatyana Gudishvili, RN's National Provider Identifier is 1407591472, issued on May 3, 2022. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Vancouver, WA. The record was last updated on May 25, 2022.