Provider Demographics
NPI:1356600142
Name:LIEB, TAMAR NOGAH (ND, LM, CPM)
Entity type:Individual
Prefix:DR
First Name:TAMAR
Middle Name:NOGAH
Last Name:LIEB
Suffix:
Gender:F
Credentials:ND, LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 H ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3226
Mailing Address - Country:US
Mailing Address - Phone:646-345-5557
Mailing Address - Fax:
Practice Address - Street 1:2376 MAIN ST
Practice Address - Street 2:SUITE #3
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-8605
Practice Address - Country:US
Practice Address - Phone:360-384-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60242583175F00000X
WAMW 60242579176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No176B00000XOther Service ProvidersMidwife