Provider Demographics
NPI:1518402528
Name:EFF, TONYA (LMP)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:EFF
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 1:1401 N ROAD 79
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-1754
Mailing Address - Country:US
Mailing Address - Phone:509-366-4320
Mailing Address - Fax:
Practice Address - Street 1:1401 N ROAD 79
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-1754
Practice Address - Country:US
Practice Address - Phone:509-366-4320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60232123225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist