Provider Demographics
NPI:1053611368
Name:TOMKINSON, TIFFANY (LMP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:TOMKINSON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 WESTLAKE AVE N
Mailing Address - Street 2:#5
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2495
Mailing Address - Country:US
Mailing Address - Phone:206-883-7564
Mailing Address - Fax:
Practice Address - Street 1:2130 WESTLAKE AVE N
Practice Address - Street 2:#5
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2495
Practice Address - Country:US
Practice Address - Phone:206-883-7564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60185680225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist