Provider Demographics
NPI:1184083784
Name:CRAM, TONJA MARIE (CO 60537894)
Entity type:Individual
Prefix:
First Name:TONJA
Middle Name:MARIE
Last Name:CRAM
Suffix:
Gender:F
Credentials:CO 60537894
Other - Prefix:
Other - First Name:TONJA
Other - Middle Name:MARIE
Other - Last Name:SAWYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2610 WETMORE AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-2927
Mailing Address - Country:US
Mailing Address - Phone:424-258-5270
Mailing Address - Fax:
Practice Address - Street 1:2610 WETMORE AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-2927
Practice Address - Country:US
Practice Address - Phone:424-258-5270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-11
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP61122132101YA0400X
WACO 60537894101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)