Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CP00001805 | WA |
NPI | 1003111915 |
---|---|
Provider Name | Ms. Tamara Anne Dow |
First Address | Kenmore, WA 98028-0133 |
Second Address | Mountlake Terrace, WA 98043-2187 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2011 |
Last Update Date | 24/01/2011 |