Individual
TIFFANY ANN MACARAEG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
611 S 132ND ST, BURIEN, WA 98168-2764
(206) 631-3600
Mailing address
4826 S 187TH PL APT D306, SEATAC, WA 98188-8635
(702) 882-4641
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60738531
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP60738531
LICENSE PRACTICAL NURSE
WA
Enumeration date
04/23/2018
Last updated
04/23/2018
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