| Doctor Name: | TARA MARIE STAEHLIN |
| NPI Number: | 1184975260 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | MC60184343 |
| Business Practice Address: | 9032 E Shorewood Dr Apt. # 317 Mercer Island, WA - 980406279 |
| Business Phone Number: | 5034591978 |
| Business Fax Number: | |
| Mailing Address: | 9032 E Shorewood Dr, Apt. # 317 MERCER ISLAND |
| State: | WA |
| Postal Code: | 980406279 |
| Phone Number: | 5034591978 |
| Fax Number: | |
| NPI Enumeration Date: | 09/28/2012 |
| NPI Last Update Date: | 09/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | MC60184343 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |