Provider Demographics
NPI:1245814045
Name:SEHER, TIFFANY ANNE (RDH)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANNE
Last Name:SEHER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3016
Mailing Address - Country:US
Mailing Address - Phone:360-425-8140
Mailing Address - Fax:
Practice Address - Street 1:1105 14TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3016
Practice Address - Country:US
Practice Address - Phone:360-425-8140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61101922124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist