Provider Demographics
NPI:1053069302
Name:WESTBROOKS, TAMRA (DAS, LAC)
Entity Type:Individual
Prefix:
First Name:TAMRA
Middle Name:
Last Name:WESTBROOKS
Suffix:
Gender:F
Credentials:DAS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 22ND ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3324
Mailing Address - Country:US
Mailing Address - Phone:571-499-9293
Mailing Address - Fax:
Practice Address - Street 1:5801 22ND ST N
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3324
Practice Address - Country:US
Practice Address - Phone:571-499-9293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC500262171100000X
VA0121001021171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist