Provider Demographics
NPI:1740425560
Name:SOL, TARA S (MSW)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:S
Last Name:SOL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E JARRETT DR
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-8852
Mailing Address - Country:US
Mailing Address - Phone:360-791-9210
Mailing Address - Fax:
Practice Address - Street 1:627 W FRANKLIN ST
Practice Address - Street 2:SUITE 6
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-3504
Practice Address - Country:US
Practice Address - Phone:360-791-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker