Individual
MIMI A TUTIHASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7210 40TH ST W STE 100, UNIVERSITY PLACE, WA 98466-4319
(253) 564-0170
(253) 965-4279
Mailing address
7210 40TH ST W STE 100, UNIVERSITY PLACE, WA 98466-4319
(253) 564-0170
(253) 965-4279
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00030531
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1044317
—
WA
01
—
126524
L & I
WA
01
—
370013715
RAILROAD
WA
01
—
8935091
CRIME VICTIMS
WA
Enumeration date
08/10/2006
Last updated
01/18/2021
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