Individual
TIFFANY HENNINGSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1701 N 13TH ST, SHELTON, WA 98584-2077
(360) 426-2653
(888) 985-0681
Mailing address
PO BOX 1668, SHELTON, WA 98584-5001
(360) 426-9549
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61594552
WA
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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