Provider Demographics
NPI:1669913844
Name:PRITCHARD, TATIANA MIKHAILOVNA (PMHNP, FNP)
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:MIKHAILOVNA
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:PMHNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 NE 7TH AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-4548
Mailing Address - Country:US
Mailing Address - Phone:360-836-4455
Mailing Address - Fax:833-553-2040
Practice Address - Street 1:10000 NE 7TH AVE STE 410
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-4548
Practice Address - Country:US
Practice Address - Phone:360-836-4455
Practice Address - Fax:833-553-2040
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60730570363LF0000X, 363LP0808X, 363LP0808X
OR201701875NP-PP363LF0000X
OR201908259NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily