Tamara Nicole Patrick, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018482 Issued in MI

Practice address

275 W Tietan St
Walla Walla, WA 99362-4363

Phone

(506) 522-0114

Fax

(931) 455-4450

NPI assigned

Nov 10, 2017

Last updated

Sep 15, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Walla Walla Physical Therapy Center Aps

  • Physical Therapist
  • Walla Walla, WA
  • NPI 1477574606
  NPD
• Malcolm Grow Medical Center

  • Department of Veterans Affairs (VA) Pharmacy
  • JB Andrews, MD
  • NPI 1477350502
  NPD

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1942713029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624363",
            "telephone_number": "506-522-0114",
            "fax_number": "931-455-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624363",
            "telephone_number": "506-522-0114",
            "fax_number": "931-455-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "TAMARA",
        "middle_name": "NICOLE",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Christopher Parrish, D.D.S.
• Patricia Parrish, OTR/L
• Amanda Eve Parry, SUDPT
• Nicole Siobhan Patching, MD
• Roshan Patel, MD
• Kristan Ann Patterson-Fowler, LICSW
• Barry Patzer
• Shelby Paulsen
• Teresa L Pavish-Paradiso, MSW/LICSW
• Keith Edward Payne, LMHC

• Physical Therapist in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.