Provider Demographics
NPI:1932574076
Name:GILL, TAMMY LOUISE (BA)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LOUISE
Last Name:GILL
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MISS
Other - First Name:TAMMY
Other - Middle Name:LOUISE
Other - Last Name:ASSELIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:44 S DAWES ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2034
Mailing Address - Country:US
Mailing Address - Phone:509-308-5228
Mailing Address - Fax:
Practice Address - Street 1:715 W COURT ST
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-4153
Practice Address - Country:US
Practice Address - Phone:509-545-6506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator