Provider Demographics
NPI:1083201032
Name:MASALA FINALE, TAIS
Entity Type:Individual
Prefix:
First Name:TAIS
Middle Name:
Last Name:MASALA FINALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAIS
Other - Middle Name:
Other - Last Name:MASALA-FINALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BD,PPD
Mailing Address - Street 1:13858 130TH PL NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2314
Mailing Address - Country:US
Mailing Address - Phone:206-945-2539
Mailing Address - Fax:
Practice Address - Street 1:13858 130TH PL NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-2314
Practice Address - Country:US
Practice Address - Phone:206-945-2539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604431905374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula