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General NPI Number Information
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NPI Number | 1922741339
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Entity Type | Individual
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Provider Name | ASHLEY THOR TANNER DO
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Gender | Female
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 1830 BICKFORD AVE STE 211
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City | SNOHOMISH
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State | WA
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Zip | 98290-1751
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Country | US
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Telephone | 360-563-5900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31001-4110
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City | PASADENA
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State | CA
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Zip | 91110-4114
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP70013177
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License Number State | WA
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