Individual
TANNA A SCRIVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
4822 S M ST, TACOMA, WA 98408-3505
(253) 202-6626
Mailing address
4822 S M ST, TACOMA, WA 98408-3505
(253) 202-6626
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA00012052
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00012052
WASHINGTON STATE DEPT OF HEALTH
WA
Enumeration date
11/21/2008
Last updated
11/21/2008
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