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General NPI Number Information
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NPI Number | 1528536182
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Entity Type | Individual
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Provider Name | TARA LEE GOLDENHOUR MSW, LSWAIC
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Gender | Female
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Dates
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Enumeration Date | 11/12/2018
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 100 N HOWARD ST STE W
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City | SPOKANE
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State | WA
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Zip | 99201-0508
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Country | US
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Telephone | 425-387-0188
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Fax |
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Provider Business Mailing Address
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Address Line | 20469 SE 159TH ST
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City | RENTON
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State | WA
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Zip | 98059-9013
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Country | US
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Telephone | 425-387-0188
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SC60823467
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License Number State | WA
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