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General NPI Number Information
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NPI Number | 1114728714
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Entity Type | Organization
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Legal Business Name | TAMARA ELAM
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 300 E 24TH ST
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City | VANCOUVER
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State | WA
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Zip | 98663-3214
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Country | US
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Telephone | 360-798-7625
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Fax | 564-227-3038
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Provider Business Mailing Address
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Address Line | 1013 NE 139TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98684-7332
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Country | US
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Telephone | 360-721-1924
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Fax | 564-227-3038
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Authorized Official
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Title or Position | LICENSED ACUPUNCTURIST
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Name | TAMARA ELAM
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Credential |
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Telephone | 360-721-1924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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