Provider Demographics
NPI:1427769496
Name:TOBIN, TARA (OT)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:TOBIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:HAUG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:6400 MACARTHUR BLVD # 7533
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-7533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6400 MACARTHUR BLVD # 7533
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7533
Practice Address - Country:US
Practice Address - Phone:360-313-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61371054225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics