Individual
MRS. TIFFANY MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
22003 66TH AVE W # M5, MOUNTLAKE TERRACE, WA 98043
(425) 321-0339
(425) 332-7208
Mailing address
20201 12TH AVE W, LYNNWOOD, WA 98036-7182
(425) 321-0339
(425) 332-7208
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
602996357
WA
175M00000X
Lay Midwife
—
—
176B00000X
Midwife
Primary
60829254
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60829254
—
WA
Enumeration date
02/08/2011
Last updated
07/10/2018
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