Provider Demographics
NPI:1235679374
Name:BARNES, TIFFANY PAIGE (MSAOM, EAMP, LAC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:PAIGE
Last Name:BARNES
Suffix:
Gender:F
Credentials:MSAOM, EAMP, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 NE 55TH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2870
Mailing Address - Country:US
Mailing Address - Phone:206-419-5481
Mailing Address - Fax:
Practice Address - Street 1:5101 NE 55TH ST APT 202
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2870
Practice Address - Country:US
Practice Address - Phone:206-419-5481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60721424171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist