Individual
TAMARA ANN COULTER DOTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2434
(208) 743-7612
(208) 746-4802
Mailing address
PO BOX 8, WAUNA, WA 98395-0008
(360) 731-2533
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7686
WI
363A00000X
Physician Assistant
Primary
PA.60417452
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699102871
—
WI
Enumeration date
10/02/2013
Last updated
12/04/2023
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