Provider Demographics
NPI:1578695722
Name:DAVIS, TAMRA (LMFT)
Entity Type:Individual
Prefix:
First Name:TAMRA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11621 57TH AVE E
Mailing Address - Street 2:#N-204
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-4385
Mailing Address - Country:US
Mailing Address - Phone:253-845-5897
Mailing Address - Fax:
Practice Address - Street 1:816 F ST SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-6121
Practice Address - Country:US
Practice Address - Phone:253-939-2202
Practice Address - Fax:253-735-1894
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002253106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist