Provider Demographics
NPI:1609148154
Name:TIPPETT, KARI LYN (LMP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LYN
Last Name:TIPPETT
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 1:19111 96TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-8708
Mailing Address - Country:US
Mailing Address - Phone:253-389-7185
Mailing Address - Fax:
Practice Address - Street 1:8114 112TH STREET CT E
Practice Address - Street 2:SUITE B
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-7820
Practice Address - Country:US
Practice Address - Phone:253-904-8397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024503175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath