Individual
SIERRA TIETGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3730 W HAPPY VALLEY RD STE 100, GLENDALE, AZ 85310-3283
(623) 277-4140
Mailing address
1728 BELLEVUE LOOP, ANCHORAGE, AK 99515-3116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
153672
AK
363A00000X
Physician Assistant
Primary
8884
AZ
Other
Enumeration date
01/10/2020
Last updated
09/21/2022
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