Provider Demographics
NPI:1528374840
Name:NOFFSINGER, TAMMY L (LMFT)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:L
Last Name:NOFFSINGER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22705 MERIDIAN AVE E UNIT B
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-7098
Mailing Address - Country:US
Mailing Address - Phone:253-262-3309
Mailing Address - Fax:253-262-3414
Practice Address - Street 1:22705 MERIDIAN AVE E UNIT B
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-7098
Practice Address - Country:US
Practice Address - Phone:253-262-3309
Practice Address - Fax:253-262-3414
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60539414106H00000X
WAVA00060538183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2067006Medicaid