Individual
TIARI GARDNER DEGRAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1010 S 336TH ST STE 120, FEDERAL WAY, WA 98003-7354
(866) 835-8091
(253) 835-7102
Mailing address
5802 162ND AVE E, SUMNER, WA 98390-3108
(253) 891-3108
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
WA
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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