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General NPI Number Information
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NPI Number | 1568884641
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Entity Type | Individual
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Provider Name | TAMARA KAY TANNINEN LMHC
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Gender | Female
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Dates
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Enumeration Date | 01/09/2014
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Last Update Date | 01/09/2014
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Provider Practice Location Address
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Address Line | 118 VISTA WAY
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City | KENNEWICK
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State | WA
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Zip | 99336-3119
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Country | US
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Telephone | 360-241-5819
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Fax | 509-967-2129
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Provider Business Mailing Address
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Address Line | PO BOX 4076
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City | WEST RICHLAND
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State | WA
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Zip | 99353-4001
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Country | US
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Telephone | 509-967-2129
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Fax | 509-967-2351
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60250630
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | LH60250630
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License Number State | WA
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