Healthcare Provider Details

I. General information

NPI: 1881371748
Provider Name (Legal Business Name): TAMIKA RACHAE FALLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/03/2023
Certification Date: 07/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 BROADWAY STE 301
TACOMA WA
98402-4454
US

IV. Provider business mailing address

2306 N ST NE APT B
AUBURN WA
98002-2913
US

V. Phone/Fax

Practice location:
  • Phone: 253-671-9909
  • Fax: 855-373-4001
Mailing address:
  • Phone: 206-487-8602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: