Provider Demographics
NPI:1952608440
Name:SLOAN, TASHA LYN (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:LYN
Last Name:SLOAN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 BROADWAY ST STE 216
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3320
Mailing Address - Country:US
Mailing Address - Phone:828-350-8152
Mailing Address - Fax:
Practice Address - Street 1:7809 NE VANCOUVER PLAZA DR STE 110
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662
Practice Address - Country:US
Practice Address - Phone:360-882-2778
Practice Address - Fax:360-604-1728
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
WA60851869104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No372600000XNursing Service Related ProvidersAdult Companion