Individual
MICHELLE TIFFANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1224 N IDAHO ST, POST FALLS, ID 83854-8615
(208) 763-1608
Mailing address
PO BOX 1749, SPIRIT LAKE, ID 83869-1607
(208) 704-1809
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA61260103
WA
225700000X
Massage Therapist
Primary
MAS-4650
ID
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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