Provider Demographics
NPI:1316169337
Name:POLLARD, TIFFANY CAROL (TIFFANY POLLARD, LAC)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:CAROL
Last Name:POLLARD
Suffix:
Gender:F
Credentials:TIFFANY POLLARD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 KIRKLAND WAY
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6219
Mailing Address - Country:US
Mailing Address - Phone:425-260-4733
Mailing Address - Fax:425-828-4008
Practice Address - Street 1:515 KIRKLAND WAY
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6219
Practice Address - Country:US
Practice Address - Phone:425-828-4000
Practice Address - Fax:425-828-4008
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002626171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist