Provider Demographics
NPI:1437022944
Name:NAIR, TARA HARIKRISHNAN
Entity type:Individual
Prefix:
First Name:TARA HARIKRISHNAN
Middle Name:
Last Name:NAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 821098
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-0999
Mailing Address - Country:US
Mailing Address - Phone:425-842-3910
Mailing Address - Fax:
Practice Address - Street 1:22232 17TH AVE SE STE 312
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-7425
Practice Address - Country:US
Practice Address - Phone:425-842-3910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health