Individual
TANA ANN VARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HCA,NAR
Contact information
Practice address
101 E PARK RD, SHELTON, WA 98584-9125
(360) 660-0567
Mailing address
101 E PARK RD, SHELTON, WA 98584-9125
(360) 660-0567
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA60794599
WA
Other
Enumeration date
11/02/2019
Last updated
11/02/2019
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