Provider Demographics
NPI:1629105887
Name:TANBAKUCHI, NATASHA SARAH
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:SARAH
Last Name:TANBAKUCHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 E SKYLINE DR STE 121
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-1668
Mailing Address - Country:US
Mailing Address - Phone:520-606-4349
Mailing Address - Fax:
Practice Address - Street 1:4525 E SKYLINE DR STE 121
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-1668
Practice Address - Country:US
Practice Address - Phone:520-606-4349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1817171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist