Provider Demographics
NPI:1912871500
Name:TATARINOVA, SVETLANA (LMT)
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:TATARINOVA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6403 S 12TH ST APT 1910
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465-1981
Mailing Address - Country:US
Mailing Address - Phone:253-287-5988
Mailing Address - Fax:
Practice Address - Street 1:25228 104TH AVE SE STE 102
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6602
Practice Address - Country:US
Practice Address - Phone:206-333-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA70047917225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist