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General NPI Number Information
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NPI Number | 1740152065
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Entity Type | Individual
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Provider Name | TAMARA L CONAWAY SUDPT
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Gender | Female
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 7017 NE HWY 99 114
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City | VANCOUVER
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State | WA
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Zip | 98665
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Country | US
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Telephone | 360-694-7484
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Fax | 360-694-7479
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Provider Business Mailing Address
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Address Line | 7017 NE HWY 99 114
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City | VANCOUVER
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State | WA
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Zip | 98665
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Country | US
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Telephone | 360-694-7484
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Fax | 360-694-7479
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 61181052
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License Number State | WA
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