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Individual

TARSHENE NICOLE DAUGHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
16703 SE MCGILLIVRAY BLVD, #215, VANCOUVER, WA 98683-4300
(360) 883-2450
(866) 935-1910
Mailing address
16703 SE MCGILLIVRAY BLVD, #215, VANCOUVER, WA 98683-4300
(360) 883-2450
(866) 935-1910

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00020385
WA

Other

Enumeration date
05/02/2012
Last updated
05/02/2012
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