SERVICES

Titan Healthcare is a safe place for people of all genders and sexual orientations.  Our staff is sensitive to the unique (as well as not so unique) needs of the LGBTQIA+ population.  We strive to make all of our patients feel safe, listened to, and respected.

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See the "supplement sex and more" page for information about Gender Affirming Voice Therapy

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**We are working really hard at Titan to improve our coding to improve the accuracy with which we document your care.  Unfortunately sometimes this means using language that we know might be triggering for some people.  

Our office, and all medical offices in the United States, are required to use a coding system known as ICD-10 (International Classification of Diseases, 10th Revision) for diagnosing our patients.  These codes are developed by the World Health Organization (WHO).  We do not have any authority over the descriptions and unfortunately these descriptions do not always align with how we define things.  For example, when we code a diagnosis to support the use of hormones for gender affirming care we use the code F64.0 which has a description of “gender dysphoria in an adult”, but also carries a descriptor of “transexualism”.  We want to ensure that our patients understand that we know there is a difference between transexualism and transgender, but unfortunately this doesn’t translate in the coding language. Unfortunately at this time a code for “transgender” doesn’t exist, but please know that WHO has already addressed this in the next revision of ICD.  When ICD-11 comes to the United States, the codes are supposed to be more accurate in their representation of transgender persons.  We do not know how soon the US will adopt ICD-11 as this will require major changes across our entire healthcare system.

For our non-binary patients, you may see diagnosis code F64.9 which indicates Gender Identity Disorder, Unspecified. This is because the current ICD does not provide any code for non-binary.  It is our hope that ICD-11 will provide a better code and description that supports you as well. 

If you ever see a code that you question on your insurance remits or in your chart, you are welcome to reach out to your provider or our coder, Tami, for a complete description of the code. Tami is happy to assist you in understanding the requirements of coding that we must follow. She can be reached directly at 360-507-8316.  You can also contact us if you want a definition of the code that was used.  

Thank you for your understanding and thank you for trusting us with your care.

Sincerely,

The Providers and Staff of Titan Healthcare

PELVIC FLOOR PHYSICAL THERAPY

Lori Waterman

Lori has been a physical therapist since 1988, working in the Olympia area since 2006 after a period of staying at home caring for her three daughters.  She completed her transitional doctorate of physical therapy (DPT) in 2011, and received board certification as an orthopedic clinical specialist (OCS) from the American Physical Therapy Association in 2012. Since June of 2010, she has been treating persons of all genders with pelvic health issues, and is board certified as a pelvic rehabilitation practitioner (PRPC) through Herman & Wallace Pelvic Rehab Institute in Seattle since 2013.   Foundational trainings that have additionally influenced her treatment approaches include advanced Visceral and Neural Manipulation training through the Barral Institute, and completion of the 6 month Integrated Systems Model with Diane Lee, PT in Canada.  Her bachelor’s degree was through Ithaca College in New York, with graduate degree through AT Still University.  
Lori is passionate about helping people restore symmetry and balance to their neuromuscular and musculoskeletal systems to allow for the greatest ease and efficiency of movement.  She loves helping others to more fully understand their bodies, in order to return to the activities that have  meaning and purpose for them.

NUTRITION THERAPY

Wellness starts with Nutrition

Carole Layton, FNTP

Our nutrition therapy services focus on gut health and overall health and wellness.  Carole focuses on systemic inflammation and gut dysbiosis to help treat underlying conditions and improve quality of life.  While weight loss is not necessarily the focus of her work, it is often a side effect!  Carole's services are covered by many insurances, but we also offer cash prices.  She provides both in person and telehealth visits based on your unique needs.  Please visit her website for more details. 

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https://www.carolelayton.com/