Healthcare Provider Details
I. General information
NPI: 1265958540
Provider Name (Legal Business Name): ZAMARA THAYRIS CAMAS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/17/2017
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5901 N LIDGERWOOD ST STE 115
SPOKANE WA
99208-1122
US
IV. Provider business mailing address
107 S DIVISION ST
SPOKANE WA
99202-1510
US
V. Phone/Fax
- Phone: 509-466-6632
- Fax:
- Phone: 509-838-4651
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | SC60868840 |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | SC60868840 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: