MEDICARE: MRS. TATYANA AULTMAN CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	812494	TX
2	367500000X	Certified Registered Nurse Anesthetist	AP30007033	WA

General Provider Information

NPI Number	:	1740244458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TATYANA AULTMAN CRNA

Provider Business Mailing Address
First Line	:	3405 E LATTIN RD
Second Line	:
City	:	WEST RICHLAND
State	:	WA
Zip	:	99353-7420
Country	:	US
Telephone Number	:	509-939-9990
Fax Number	:

Provider Business Practice Location Address
First Line	:	3405 E LATTIN RD
Second Line	:
City	:	WEST RICHLAND
State	:	WA
Zip	:	99353-7420
Country	:	US
Telephone Number	:	509-939-9990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	03/11/2026

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