Provider Demographics
NPI:1528503547
Name:INRIG, TIFFANIE RAYANNE (LMT)
Entity type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:RAYANNE
Last Name:INRIG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12305 120TH AVE NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-820-2777
Mailing Address - Fax:425-821-5528
Practice Address - Street 1:12305 120TH AVE NE
Practice Address - Street 2:SUITE A
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-820-2777
Practice Address - Fax:425-821-5528
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00008759225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist