Individual
MS. TANYA RENE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.P.S/ R.A.C
Contact information
Practice address
910 W BOONE AVE, SPOKANE, WA 99201-5029
(509) 325-7232
(509) 325-4580
Mailing address
910 W BOONE AVE, SPOKANE, WA 99201-5029
(509) 325-7232
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA61148913
N.A. R.
WA
Enumeration date
04/16/2021
Last updated
04/16/2021
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