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General NPI Number Information
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NPI Number | 1336627447
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Entity Type | Individual
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Provider Name | DAINA TAGAVI PHD
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Gender | Female
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 9918 284TH AVE NE
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City | CARNATION
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State | WA
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Zip | 98014-8801
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Country | US
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Telephone | 661-670-7783
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Fax |
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Provider Business Mailing Address
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Address Line | 15814 9TH AVE NE
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City | SHORELINE
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State | WA
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Zip | 98155-6245
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Country | US
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Telephone | 661-670-7783
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY61229064
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License Number State | WA
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