Individual
TARA MICHELLE SHADLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 TACOMA AVE S STE 201, TACOMA, WA 98402-1903
(253) 396-5800
Mailing address
12410 132ND STREET CT E, PUYALLUP, WA 98374-4663
(253) 224-4525
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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