Provider Demographics
NPI:1649517269
Name:TEMPKE, TRISTA LYNN MARTIN
Entity type:Individual
Prefix:MRS
First Name:TRISTA
Middle Name:LYNN MARTIN
Last Name:TEMPKE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:TRISTA
Other - Middle Name:LYNN
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1367 BIGLEOW AVE NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506
Mailing Address - Country:US
Mailing Address - Phone:206-427-3745
Mailing Address - Fax:
Practice Address - Street 1:1367 BIGLEOW AVE NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506
Practice Address - Country:US
Practice Address - Phone:206-427-3745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst