Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | RC00038434 | WA |
NPI | 1003099383 |
---|---|
Provider Name | Ms. Tammy Marie Stewart |
First Address | Lakewood, WA 98499-2858 |
Second Address | Lakewood, WA 98499-2858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2007 |
Last Update Date | 10/12/2007 |