| NPI | 1497378657 |
|---|---|
| Former Name | TAMRA KATHLEEN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61072945) |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2024-10-17 |