MEDICARE: TAMARA DICKSON N.D.

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	175F00000X	Naturopath	NT60116127	WA

General Provider Information

NPI Number	:	1861724239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA DICKSON N.D.

Provider Business Mailing Address
First Line	:	1409 NW 85TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98117-4237
Country	:	US
Telephone Number	:	206-781-2206
Fax Number	:	206-783-3949

Provider Business Practice Location Address
First Line	:	1409 NW 85TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98117-4237
Country	:	US
Telephone Number	:	206-781-2206
Fax Number	:	206-783-3949

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

Provider Enumeration Date	:	02/09/2010
Last Update Date	:	02/09/2010

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