Provider Demographics
NPI:1518153717
Name:TINKER, ALYSSA LEIGH (LMP)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:LEIGH
Last Name:TINKER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8167 AUSTIN PL
Mailing Address - Street 2:
Mailing Address - City:FORT LEWIS
Mailing Address - State:WA
Mailing Address - Zip Code:98433-1326
Mailing Address - Country:US
Mailing Address - Phone:720-839-7320
Mailing Address - Fax:
Practice Address - Street 1:6223 112TH ST E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-4316
Practice Address - Country:US
Practice Address - Phone:253-286-2211
Practice Address - Fax:253-286-2152
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024377225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist