Provider Demographics
NPI:1972963080
Name:BARLOW, TARALEE LYNN (LMP)
Entity Type:Individual
Prefix:
First Name:TARALEE
Middle Name:LYNN
Last Name:BARLOW
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 YAKIMA AVE
Mailing Address - Street 2:#A
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4448
Mailing Address - Country:US
Mailing Address - Phone:915-588-9312
Mailing Address - Fax:
Practice Address - Street 1:1214 YAKIMA AVE
Practice Address - Street 2:#A
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4448
Practice Address - Country:US
Practice Address - Phone:915-588-9312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60630109225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist