Provider Demographics
NPI:1639346323
Name:BATISTE, TIM (LAC)
Entity Type:Individual
Prefix:MR
First Name:TIM
Middle Name:
Last Name:BATISTE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7249 FISKE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:WA
Mailing Address - Zip Code:98236-9303
Mailing Address - Country:US
Mailing Address - Phone:360-221-8595
Mailing Address - Fax:
Practice Address - Street 1:207 ANTHES RD
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-9722
Practice Address - Country:US
Practice Address - Phone:360-221-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002967171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist