Healthcare Provider Details

I. General information

NPI: 1699718544
Provider Name (Legal Business Name): TAMARA E THOMPSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 CREEKSIDE LOOP
YAKIMA WA
98902-4874
US

IV. Provider business mailing address

PO BOX 8051
YAKIMA WA
98908-0051
US

V. Phone/Fax

Practice location:
  • Phone: 509-972-4865
  • Fax: 509-469-1905
Mailing address:
  • Phone: 509-469-1903
  • Fax: 509-469-1905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30003083
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP30003083
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberAP30003083
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00077038
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: