Individual
DR. MITCHELL VAN TIPPETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
551 E HAWTHORNE RD, SPOKANE, WA 99218-1417
(509) 489-2369
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 489-2369
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60250890
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00
RESIDENT
WA
Enumeration date
06/19/2009
Last updated
04/08/2021
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