Provider Demographics
NPI:1205210994
Name:AUXIER, TIFFANY (MT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:AUXIER
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 EASTGATE ST
Mailing Address - Street 2:#110
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2554
Mailing Address - Country:US
Mailing Address - Phone:509-527-1156
Mailing Address - Fax:509-522-4933
Practice Address - Street 1:2316 EASTGATE ST
Practice Address - Street 2:#110
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2554
Practice Address - Country:US
Practice Address - Phone:509-527-1156
Practice Address - Fax:509-522-4933
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60563953174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist