Individual
DR. TIFFANIE FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1660 S COLUMBIAN WAY, PRIMARY CARE CLINIC (S-PCC-123), SEATTLE, WA 98108-1532
(206) 277-4434
Mailing address
1660 S COLUMBIAN WAY, PRIMARY CARE CLINIC (S-PCC-123), SEATTLE, WA 98108-1532
(206) 277-4434
Taxonomy
Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
34715
TX
103TH0004X
Health Psychologist
Primary
6573
OH
103TH0004X
Health Psychologist
PY60406906
WA
Other
Enumeration date
10/15/2008
Last updated
07/24/2015
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