Active NPI
Tambra Lin Donohue
- Clinical Psychologist
- Lacey, WA
National Provider Identifier
1457640492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60025092
- Practice address
- 420 Golf Club Rd SE
Lacey, WA 98503-1048 - Phone
- (360) 923-1884
- NPI assigned
- Mar 30, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY60025092 | WA | Primary |
Addresses
Primary practice location
420 Golf Club Rd SE
Lacey, WA 98503-1048
Mailing address
5931 S I St
Tacoma, WA 98408-3440
Phone (360) 915-3668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60025092 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301443200000",
"number": "1457640492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5931 S I ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984083440",
"telephone_number": "360-915-3668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 GOLF CLUB RD SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985031048",
"telephone_number": "360-923-1884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONOHUE",
"first_name": "TAMBRA",
"middle_name": "LIN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-30",
"last_updated": "2011-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60025092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.