Maverick Miriam Tang, CDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60993506 Issued in WA

Practice address

515 Lakeway Dr
Bellingham, WA 98225-5233

Phone

(360) 676-2187

NPI assigned

Apr 5, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miriam Tang Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1952834095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 LINCOLN ST APT 3",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982296252",
            "telephone_number": "206-453-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 LAKEWAY DR",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255233",
            "telephone_number": "360-676-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "MAVERICK",
        "middle_name": "MIRIAM",
        "credential": "CDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60993506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRIAM",
            "last_name": "TANG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chee Yeow Tan, M.D.
• Jan Vincent Tan, DC
• Wendy Lucille Tan, ARNP
• Karman L Tandon, MD
• David Tang
• Hannah R Tanha, FNP-C
• Abigail Tankersley, LMHC
• Taproot Medicine, LLC
• Warren S Taranow, DO
• Scott D Tarleton, M.D.

• Addiction (Substance Use Disorder) Counselor in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.