Individual
JAZMYN PRINCESS CARROLL TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
11025 CANYON RD E STE A, PUYALLUP, WA 98373-4268
(253) 548-0453
Mailing address
PO BOX 5299, MS: 820-5-PCO, TACOMA, WA 98415-0299
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60926405
WA
363LP2300X
Primary Care Nurse Practitioner
AP60926405
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/03/2017
Last updated
08/08/2023
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