Individual
TARA ALYSSA FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7424 BRIDGEPORT WAY W STE 201, LAKEWOOD, WA 98499-8134
(253) 240-2110
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61610396
WA
Other
Enumeration date
05/09/2023
Last updated
03/10/2025
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