Individual
TAMMY WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1227 GOERIG RD, STE H, WOODLAND, WA 98674
(360) 225-1200
Mailing address
1227 GOERIG RD, STE H, WOODLAND, WA 98674
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
WA
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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