Provider Demographics
NPI:1972649663
Name:FOSS, TAMMY Y (LMP-C)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:Y
Last Name:FOSS
Suffix:
Gender:F
Credentials:LMP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15326 NE 6TH PLACE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007
Mailing Address - Country:US
Mailing Address - Phone:425-558-9441
Mailing Address - Fax:
Practice Address - Street 1:14850 LAKE HILLS BLVD STE B4
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-5800
Practice Address - Country:US
Practice Address - Phone:425-558-9441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017046174400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist