Provider Demographics
NPI:1356416275
Name:TARRANT, TIFFANY (ARNP)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:
Last Name:TARRANT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 N 62ND ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5618
Mailing Address - Country:US
Mailing Address - Phone:206-781-1501
Mailing Address - Fax:
Practice Address - Street 1:2124 FOURTH AVENUE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2311
Practice Address - Country:US
Practice Address - Phone:206-296-4960
Practice Address - Fax:206-296-0184
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005768363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9629767Medicaid
WA9629767Medicaid