Provider Demographics
NPI:1588729925
Name:ANDERSON, TAMARA LOUISE (MASTERS)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LOUISE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 NW ALDER PL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-3214
Mailing Address - Country:US
Mailing Address - Phone:425-392-9774
Mailing Address - Fax:425-369-0354
Practice Address - Street 1:40 NW ALDER PL
Practice Address - Street 2:SUITE 202
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-3214
Practice Address - Country:US
Practice Address - Phone:425-392-9774
Practice Address - Fax:425-369-0354
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003698101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health