Provider Demographics
NPI:1760783484
Name:TIPPIE QUESADA, JENNIFER LOUISE (CD)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LOUISE
Last Name:TIPPIE QUESADA
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 BIRCHWOOD AVE
Mailing Address - Street 2:103
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-9203
Mailing Address - Country:US
Mailing Address - Phone:253-961-8394
Mailing Address - Fax:
Practice Address - Street 1:1420 BIRCHWOOD AVE
Practice Address - Street 2:103
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-9203
Practice Address - Country:US
Practice Address - Phone:253-961-8394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602 997 322374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula