Provider Demographics
NPI:1780465799
Name:SCHABER, TIFFANY (ARNP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:SCHABER
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 1:3140 PHEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-5202
Mailing Address - Country:US
Mailing Address - Phone:509-217-7404
Mailing Address - Fax:
Practice Address - Street 1:1300 E MULLAN AVE STE 1600
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6054
Practice Address - Country:US
Practice Address - Phone:208-625-4965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61465795363LF0000X
ID77759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily