Provider Demographics
NPI:1750942942
Name:TRETIAKOVA, CATHERINE (CPNP-PC, DNP)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:TRETIAKOVA
Suffix:
Gender:F
Credentials:CPNP-PC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2848 E BROWN RD UNIT 47
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-5414
Mailing Address - Country:US
Mailing Address - Phone:602-380-8184
Mailing Address - Fax:
Practice Address - Street 1:2005 W MAIN ST STE 120
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-4311
Practice Address - Country:US
Practice Address - Phone:360-882-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61652979363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics