Provider Demographics
NPI:1043103724
Name:SLATER, TIFFANY LYNNE
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LYNNE
Last Name:SLATER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 HILLRISE CT NE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-9209
Mailing Address - Country:US
Mailing Address - Phone:360-900-7899
Mailing Address - Fax:
Practice Address - Street 1:874 HILLRISE CT NE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-9209
Practice Address - Country:US
Practice Address - Phone:360-447-0245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist