Tatyana Gudishvili, RN is a
Custodial Care Facility - Adult Care Home based in Vancouver, Washington. Tatyana Gudishvili is licensed to practice in Washington (license number 754775) and her current practice location is
22300 Ne 58th St, Vancouver, Washington. She can be reached at her office (for appointments etc.) via phone at
(360) 852-3884.
NPI number for Tatyana Gudishvili is 1407591472 and her current mailing address is 22300 Ne 58th St, Vancouver, Washington. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1407591472.
Provider's Profile
Full Name | Tatyana Gudishvili |
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Gender | Female |
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Speciality | Custodial Care Facility - Adult Care Home |
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Location | 22300 Ne 58th St, Vancouver, Washington |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1407591472
- Provider Enumeration Date: 05/03/2022
- Last Update Date: 05/25/2022
Medical Identifiers
Medical identifiers for Tatyana Gudishvili such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407591472 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | RN00149858 (Washington) | Secondary |
311ZA0620X | Custodial Care Facility - Adult Care Home | 754775 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tatyana Gudishvili is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tatyana Gudishvili, RN 22300 Ne 58th St, Vancouver, WA 98682-9046 Ph: (360) 852-3884 | Tatyana Gudishvili, RN 22300 Ne 58th St, Vancouver, WA 98682-9046 Ph: (360) 852-3884 |
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