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Individual

MS. TIANA ANNALICE STROUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CDPT

Contact information

Practice address
11818 SE MILL PLAIN BLVD STE 307, VANCOUVER, WA 98684-7017
(360) 750-9635
Mailing address
11818 SE MILL PLAIN BLVD STE 307, VANCOUVER, WA 98684-5089
(360) 750-9635

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CO60613645
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CO60613645
CDPT
WA
Enumeration date
10/26/2016
Last updated
10/26/2016
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