Healthcare Provider Details

I. General information

NPI: 1922544782
Provider Name (Legal Business Name): TAMAR YAHAWAHDAH LMP MA60533856
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2017
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S 336TH ST STE 102
FEDERAL WAY WA
98003-6389
US

IV. Provider business mailing address

4002 S M ST STE I
TACOMA WA
98418-3800
US

V. Phone/Fax

Practice location:
  • Phone: 253-226-7783
  • Fax:
Mailing address:
  • Phone: 253-226-7783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60533856
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: