Provider Demographics
NPI:1184191207
Name:BOOKER, TAMARA LYNN
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LYNN
Last Name:BOOKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:LYNN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSWAIC, CMHS, MSW
Mailing Address - Street 1:1201 JADWIN AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3430
Mailing Address - Country:US
Mailing Address - Phone:509-554-4006
Mailing Address - Fax:509-578-1402
Practice Address - Street 1:1201 JADWIN AVE STE 104
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3430
Practice Address - Country:US
Practice Address - Phone:509-554-4006
Practice Address - Fax:509-578-1402
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61136218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health