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Individual

TAHLIA MONIQUE CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2901 FALK RD, VANCOUVER, WA 98661-6392
(360) 313-1000
Mailing address
907 SE PARK CREST AVE APT D15, VANCOUVER, WA 98683-8379
(509) 491-0917

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT61382901
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT61382901
WASHINGTON STATE DEPARTMENT OF HEALTH OCCUPATIONAL THERAPIST LICENSE
WA
Enumeration date
01/10/2023
Last updated
01/10/2023
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