Individual
ADRIA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STUDENT, PTA
Contact information
Practice address
2209 N 30TH ST STE 5, TACOMA, WA 98403-3352
(253) 446-7176
Mailing address
5620 112TH ST E STE 215, PUYALLUP, WA 98373-3206
(206) 708-3850
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MHCA.MC.61309127
WA
225200000X
Physical Therapy Assistant
60567605
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/06/2021
Last updated
06/05/2026
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