Provider Demographics
NPI:1962596619
Name:ALL WOMEN'S HEALTH, P.S.
Entity type:Organization
Organization Name:ALL WOMEN'S HEALTH, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GITTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-471-3464
Mailing Address - Street 1:3711 PACIFIC AVE
Mailing Address - Street 2:STE. 200
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-7800
Mailing Address - Country:US
Mailing Address - Phone:253-471-3464
Mailing Address - Fax:253-474-6880
Practice Address - Street 1:3711 PACIFIC AVE
Practice Address - Street 2:STE. 200
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-7800
Practice Address - Country:US
Practice Address - Phone:253-471-3464
Practice Address - Fax:253-474-6880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7111875Medicaid