Active NPI
Tamara A Dudley
- Counselor
- Taholah, WA
National Provider Identifier
1710112982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- RC 00040793
- Practice address
- 1505 Kla-Ook-Wa Drive
Taholah, WA 98587-0219 - Phone
- (360) 276-4405
- Fax
- (360) 276-4104
- NPI assigned
- May 18, 2009
- Last updated
- May 18, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | RC 00040793 | WA | Primary |
Addresses
Primary practice location
1505 Kla-Ook-Wa Drive
Taholah, WA 98587-0219
Mailing address
207 N Lewis St
Aberdeen, WA 98520-7632
Phone (360) 276-4405
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 |
|---|---|---|---|
| RC 00040793 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242604800000",
"number": "1710112982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 N LEWIS ST",
"city": "ABERDEEN",
"state": "WA",
"postal_code": "985207632",
"telephone_number": "360-276-4405",
"fax_number": "360-276-4104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 KLA-OOK-WA DRIVE",
"city": "TAHOLAH",
"state": "WA",
"postal_code": "985870219",
"telephone_number": "360-276-4405",
"fax_number": "360-276-4104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "TAMARA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-18",
"last_updated": "2009-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "RC 00040793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taholah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.