=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194677096
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YEVGENIYA TITOV PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2026
-----------------------------------------------------
Last Update Date | 02/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15921 W FOUR MOUND RD
-----------------------------------------------------
City | NINE MILE FALLS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99026-9705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-599-9195
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15921 W FOUR MOUND RD
-----------------------------------------------------
City | NINE MILE FALLS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99026-9705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 70088260
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------