Provider Demographics
NPI:1972258861
Name:VANOVER, TAMARA STONE (MS)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:STONE
Last Name:VANOVER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E 4TH ST STE 12
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-3000
Mailing Address - Country:US
Mailing Address - Phone:360-565-2602
Mailing Address - Fax:360-417-2410
Practice Address - Street 1:223 E 4TH ST STE 12
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3000
Practice Address - Country:US
Practice Address - Phone:360-565-2602
Practice Address - Fax:360-417-2410
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator