Tamara Dziadek, PT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

PT00006788 Issued in WA

Practice address

1106 Hazel St
Port Angeles, WA 98363-2302

Phone

(360) 417-9484

Fax

(360) 417-8826

NPI assigned

Jul 16, 2005

Last updated

Feb 21, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424476800000",
    "number": "1417956061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 HAZEL ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983632302",
            "telephone_number": "360-417-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 HAZEL ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983632302",
            "telephone_number": "360-417-9484",
            "fax_number": "360-417-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIADEK",
        "first_name": "TAMARA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-16",
        "last_updated": "2015-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006788",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WA",
            "license": "PT00006788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7093230",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RR MEDICAREB",
            "identifier": "P00209911",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jurate Sliauzyte Duffy, M.D.
• Jacqueline Dufresne, LICSW-A
• Edward H Dumontier, M.D.
• Ryan Dunning, PA-C
• Tara Eileen Dupont
• Daniel Carl Eads
• Tracy Lanell Eastes
• Elena Skye Eastman, OTR/L
• Lillian Effie Easton, ARNP
• Sheila Renee Eastwood, MA

• Geriatric Physical Therapist in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Geriatric Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.