Most Relevant Information
Provider Data
| NPI Number: | 1003581778 |
| Provider Name: | NICOLE A TATUM |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/13/2021 |
| Last Updated: | 08/13/2021 |
Provider Practice Location
402 S 4TH AVE
YAKIMA
WA
989023546
Practice Location Phone/Fax
| Phone: | 5095754084 |
| Fax: |
Provider Mailing Location
PO BOX 959
YAKIMA
WA
989070959
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |