Individual
TAMARA LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
6700 MARTIN WAY E STE 117, OLYMPIA, WA 98516-5586
(360) 413-6910
Mailing address
6700 MARTIN WAY E STE 117, OLYMPIA, WA 98516-5586
(360) 413-6910
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO60737379
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP61026957
WA
Other
Enumeration date
07/10/2017
Last updated
05/13/2022
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