Individual
TINA MARIE BYRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
803 VANDERCOOK WAY STE 5, LONGVIEW, WA 98632-4039
(360) 200-2892
Mailing address
803 VANDERCOOK WAY STE 5, LONGVIEW, WA 98632-4039
(360) 200-2892
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MA60681429
WA
Other
Enumeration date
10/13/2016
Last updated
05/03/2021
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