Individual
MS. TIFFANY E MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
(206) 433-2413
Mailing address
150 SW 156TH ST APT 205, BURIEN, WA 98166-2558
(206) 445-8469
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
60163833
WA
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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