Provider Demographics
NPI:1003843525
Name:CRABB, TIFFANY C (PA-C)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:C
Last Name:CRABB
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:SANDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1802 YAKIMA AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5303
Mailing Address - Country:US
Mailing Address - Phone:253-426-6272
Mailing Address - Fax:253-426-4060
Practice Address - Street 1:1802 YAKIMA AVE STE 104
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-5303
Practice Address - Country:US
Practice Address - Phone:253-426-6272
Practice Address - Fax:253-426-4060
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10005100363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0215352OtherLIWA
WA1000098Medicaid
WA2156SAOtherBSWA
WAG8862349Medicare PIN
WA8468894Medicaid