Provider Demographics
NPI:1457028870
Name:ANDERSON, TAMARA MARIE (DENTAL HYGIENIST RDH)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:MARIE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9112 N FIVE MILE RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-8426
Mailing Address - Country:US
Mailing Address - Phone:509-844-7030
Mailing Address - Fax:
Practice Address - Street 1:9112 N FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-8426
Practice Address - Country:US
Practice Address - Phone:509-844-7030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00006892124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist