Individual
AMELIA-JO NICOLE TATU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11415 NE 128TH ST STE 40, KIRKLAND, WA 98034-6315
(425) 307-1815
Mailing address
913 S JACKSON ST UNIT 327, SEATTLE, WA 98104-5054
(608) 548-4633
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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