Provider Demographics
NPI:1356789481
Name:RIGGS, TIA MICHAEL LECHAUN (LMP)
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:MICHAEL LECHAUN
Last Name:RIGGS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 BASIN ST SW
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:WA
Mailing Address - Zip Code:98823-2135
Mailing Address - Country:US
Mailing Address - Phone:509-754-2461
Mailing Address - Fax:
Practice Address - Street 1:1519 BASIN ST SW
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:WA
Practice Address - Zip Code:98823-2135
Practice Address - Country:US
Practice Address - Phone:509-754-2461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60134356172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist