MEDICARE: TAMARA KANE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	09925939	CO

General Provider Information

NPI Number	:	1043860729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA KANE

Provider Business Mailing Address
First Line	:	424 VANCE ST
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-1676
Country	:	US
Telephone Number	:	303-946-3267
Fax Number	:

Provider Business Practice Location Address
First Line	:	9301 LAS RAMBLAS CT UNIT D
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-4227
Country	:	US
Telephone Number	:	720-828-7355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2019
Last Update Date	:	09/16/2019

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Directions to “ TAMARA KANE ” Practice Location

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