MEDICARE: TANYA K STURM CDP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	60642698	WA

General Provider Information

NPI Number	:	1568945228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA K STURM CDP

Provider Business Mailing Address
First Line	:	910 W BOONE AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-5029
Country	:	US
Telephone Number	:	509-325-7232
Fax Number	:	509-325-4712

Provider Business Practice Location Address
First Line	:	910 W BOONE AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-5029
Country	:	US
Telephone Number	:	509-325-7232
Fax Number	:	509-325-4712

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	09/10/2018

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Directions to “ TANYA K STURM CDP” Practice Location

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