Provider Demographics
NPI:1912131020
Name:PAISANO, TARA ASHLEY-FINLEY (LMP)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:ASHLEY-FINLEY
Last Name:PAISANO
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 1:925 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-2033
Mailing Address - Country:US
Mailing Address - Phone:509-295-1646
Mailing Address - Fax:
Practice Address - Street 1:925 8TH ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2033
Practice Address - Country:US
Practice Address - Phone:509-295-1646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA538715-07225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist