Provider Demographics
NPI:1225460793
Name:VOS, TAMMIE (PT)
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:VOS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TAMMIE
Other - Middle Name:
Other - Last Name:AZOLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:599 FARRINGTON HWY
Mailing Address - Street 2:STE 102
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2028
Mailing Address - Country:US
Mailing Address - Phone:808-674-1142
Mailing Address - Fax:808-674-1143
Practice Address - Street 1:1845 NORTHWESTERN DR STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1157
Practice Address - Country:US
Practice Address - Phone:915-875-1559
Practice Address - Fax:915-877-9357
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1304187225100000X
NMPT5309225100000X
NV2871225100000X
HIPT-5195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX385634601Medicaid
NVV36885Medicare PIN