Provider Demographics
NPI:1225409667
Name:LEWIS, TANYA MURDOCK (MS, MA, LMFT)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:MURDOCK
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS, MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 JUDSON ST
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1219
Mailing Address - Country:US
Mailing Address - Phone:253-722-6533
Mailing Address - Fax:
Practice Address - Street 1:3003 JUDSON ST
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1219
Practice Address - Country:US
Practice Address - Phone:253-722-6533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60503003101YM0800X
WALF60803096106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health