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Organization

VIVA, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIVA JANE TAPPER PHD, ARNP (PRESIDENT)
(360) 379-3500
Entity
Organization

Contact information

Practice address
281A LANE DECHANTAL, PORT TOWNSEND, WA 98368
(360) 379-3500
Mailing address
281A LANE DECHANTAL, PORT TOWNSEND, WA 98368
(360) 379-3500

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
AP30004411
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AB34136
PTAN
WA
Enumeration date
06/18/2010
Last updated
06/18/2010
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