Provider Demographics
NPI:1215358585
Name:LITTLE, ASHLEY V (DO)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:V
Last Name:LITTLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5580 NORDIC PL
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-9138
Mailing Address - Country:US
Mailing Address - Phone:360-384-1511
Mailing Address - Fax:360-384-5758
Practice Address - Street 1:521 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:TACOMA FAMILY MEDICINE
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4238
Practice Address - Country:US
Practice Address - Phone:253-792-6680
Practice Address - Fax:253-403-2915
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAOP60764101207Q00000X
WAOL60568312390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine