Provider Demographics
NPI:1740802149
Name:TASHJIAN, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:TASHJIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4895 WINESKIN CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-2693
Mailing Address - Country:US
Mailing Address - Phone:325-201-3351
Mailing Address - Fax:
Practice Address - Street 1:2565 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3119
Practice Address - Country:US
Practice Address - Phone:719-632-3510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)