Healthcare Provider Details

I. General information

NPI: 1184214611
Provider Name (Legal Business Name): TAMARA PERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 N HENDERSON RD STE 8
ARLINGTON VA
22203-2485
US

IV. Provider business mailing address

4141 N HENDERSON RD STE 8
ARLINGTON VA
22203-2485
US

V. Phone/Fax

Practice location:
  • Phone: 571-777-9210
  • Fax:
Mailing address:
  • Phone: 571-777-9210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: