Individual
TATE J LANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7600 NE 41ST ST STE 200, VANCOUVER, WA 98662-6772
(360) 512-3856
Mailing address
PO BOX 11510, WESTMINSTER, CA 92685-1510
(866) 883-5375
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60079873
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60079873
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500610653
—
OR
05
—
9661455
—
WA
Enumeration date
05/29/2009
Last updated
02/09/2024
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