Provider Demographics
NPI:1912036716
Name:COXON, TANI (LMP)
Entity Type:Individual
Prefix:
First Name:TANI
Middle Name:
Last Name:COXON
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:PO BOX 30334
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98228-2334
Mailing Address - Country:US
Mailing Address - Phone:425-772-8377
Mailing Address - Fax:
Practice Address - Street 1:23710 EDMONDS WAY
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8978
Practice Address - Country:US
Practice Address - Phone:425-772-8377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist