Individual
MRS. TANIA MILAD MATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3950 KEENE ROAD, WEST RICHLAND, WA 99353
(509) 942-3130
(509) 628-8335
Mailing address
3900 S ZINTEL WAY, KENNEWICK, WA 99338
(509) 942-3627
(509) 942-2268
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
01060593
IN
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD00048517
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200527760
—
IN
05
—
8493512
—
WA
Enumeration date
07/19/2006
Last updated
06/17/2021
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