Provider Demographics
NPI:1467698977
Name:DALTON, TAIT G (MD)
Entity Type:Individual
Prefix:DR
First Name:TAIT
Middle Name:G
Last Name:DALTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4301 S PINE ST STE 301
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7206
Mailing Address - Country:US
Mailing Address - Phone:253-476-6500
Mailing Address - Fax:253-476-6550
Practice Address - Street 1:4301 S PINE ST STE 301
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7206
Practice Address - Country:US
Practice Address - Phone:253-476-6500
Practice Address - Fax:253-476-6547
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2010-05772084P0800X
WAMD610275362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry