Provider Demographics
NPI:1053705509
Name:SIERRA, TAMMARA LARAE (PTA)
Entity type:Individual
Prefix:MRS
First Name:TAMMARA
Middle Name:LARAE
Last Name:SIERRA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7816 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-4068
Mailing Address - Country:US
Mailing Address - Phone:720-737-7497
Mailing Address - Fax:
Practice Address - Street 1:7816 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-4068
Practice Address - Country:US
Practice Address - Phone:720-737-7497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTA.0012074225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant