Provider Demographics
NPI:1245526375
Name:HEMINGWAY, ROBYNE TIFFEN (LAC)
Entity type:Individual
Prefix:
First Name:ROBYNE
Middle Name:TIFFEN
Last Name:HEMINGWAY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:TIFFEN
Other - Last Name:HEMINGWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:2989 SW RAVENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-6426
Mailing Address - Country:US
Mailing Address - Phone:541-761-8582
Mailing Address - Fax:
Practice Address - Street 1:2989 SW RAVENWOOD DR
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-6426
Practice Address - Country:US
Practice Address - Phone:541-761-8582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00941171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist