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General NPI Number Information
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NPI Number | 1720511256
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Entity Type | Organization
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Legal Business Name | J. DALE HOWARD, M.D.
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 1919 N PEARL ST STE C3
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City | TACOMA
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State | WA
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Zip | 98406-2490
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Country | US
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Telephone | 253-759-4881
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Fax | 253-759-4692
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Provider Business Mailing Address
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Address Line | 1919 N PEARL ST STE C3
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City | TACOMA
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State | WA
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Zip | 98406-2490
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Country | US
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Telephone | 253-759-4881
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Fax | 253-759-4692
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES DALE HOWARD
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Credential | MD.
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Telephone | 253-759-4881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | MD00014521
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License Number State | WA
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