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NPI Code Detail

MEDICARE: TANAN WATSON

MEDICARE:   TANAN  WATSON
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
1103K00000XBehavior AnalystCG60456429WA

General Provider Information

NPI Number : 1689090938
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANAN WATSON
Provider Business Mailing Address
First Line : 901 N MONROE ST STE 200
Second Line :
City : SPOKANE
State : WA
Zip : 99201-2148
Country : US
Telephone Number : 509-209-2728
Fax Number :
Provider Business Practice Location Address
First Line : 901 N MONROE ST STE 200
Second Line :
City : SPOKANE
State : WA
Zip : 99201-2148
Country : US
Telephone Number : 509-209-2728
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2014
Last Update Date : 03/11/2014

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Directions to “ TANAN WATSON ” Practice Location

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