Provider Demographics
NPI:1124210299
Name:DEAN, TARI MAE (LMP)
Entity Type:Individual
Prefix:MS
First Name:TARI
Middle Name:MAE
Last Name:DEAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8509 222ND ST SW # A
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8153
Mailing Address - Country:US
Mailing Address - Phone:206-374-2963
Mailing Address - Fax:
Practice Address - Street 1:1429 N 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6706
Practice Address - Country:US
Practice Address - Phone:206-374-2963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist