| Doctor Name: | TAWNA L BARCK |
| NPI Number: | 1497158992 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | |
| Business Practice Address: | 310 S Roosevelt Goldendale, WA - 98620 |
| Business Phone Number: | 5097734022 |
| Business Fax Number: | |
| Mailing Address: | 8904 Ne 15th Ave C25, VANCOUVER |
| State: | WA |
| Postal Code: | 98665 |
| Phone Number: | 9079472866 |
| Fax Number: | |
| NPI Enumeration Date: | 09/29/2014 |
| NPI Last Update Date: | 09/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |