Provider Demographics
NPI:1013386283
Name:KINGSLEY, TIFFANY NOEL (BA)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:NOEL
Last Name:KINGSLEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:N
Other - Last Name:FEIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 14TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5275
Mailing Address - Country:US
Mailing Address - Phone:206-402-3168
Mailing Address - Fax:206-329-1256
Practice Address - Street 1:225 14TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5275
Practice Address - Country:US
Practice Address - Phone:206-402-3168
Practice Address - Fax:206-329-1256
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61274766101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH61274766OtherLICENSE