Basic Information
| Provider Information | |||||||||
| NPI: | 1104894484 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | TAWNA | ||||||||
| MiddleName: | REED | ||||||||
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| Credential: | M.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 209 MILWAUKEE STREET | ||||||||
| Address2: | |||||||||
| City: | MT. VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604197575 | ||||||||
| FaxNumber: | 3604284354 | ||||||||
| Practice Location | |||||||||
| Address1: | 609 N SHORE DR | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982264407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606766000 | ||||||||
| FaxNumber: | 3606766006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 04/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | RC00030651 | WA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.