NPI 1003585308
Tiawana E Dickerson
Practice location
- Address
- 1007 Koala Dr, Omak, WA 98841-9247
- Phone
- (509) 826-6191
- Fax
- (509) 826-3029
Registered specialties
Peer Specialist
Primary
Registry record
- NPI
- 1003585308
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 9 Sep 2021
- Record last updated
- 9 Sep 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.