Provider Demographics
NPI:1710606322
Name:PERKINS, TASHA NICOLE (LMFTA)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:NICOLE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:NICOLE
Other - Last Name:ENGLISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1011 E MAIN STE 103
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-6768
Mailing Address - Country:US
Mailing Address - Phone:253-693-0187
Mailing Address - Fax:
Practice Address - Street 1:1011 E MAIN STE 103
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-6768
Practice Address - Country:US
Practice Address - Phone:253-693-0187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61166052106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist