Individual
TIA DUNHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
11719 NE 95TH ST STE A, VANCOUVER, WA 98682-2444
(360) 954-8482
Mailing address
PO BOX 1678, VANCOUVER, WA 98668-1678
(360) 954-8482
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WA
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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