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NPI Code Detail

MEDICARE: MS. TIFFANY KUESPERT

MEDICARE: MS. TIFFANY KUESPERT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA00022290WA

General Provider Information

NPI Number : 1417246919
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TIFFANY KUESPERT
Provider Business Mailing Address
First Line : 2201 SW HOLDEN ST APT E106
Second Line :
City : SEATTLE
State : WA
Zip : 98106-1767
Country : US
Telephone Number : 206-427-1133
Fax Number :
Provider Business Practice Location Address
First Line : 2821 NW MARKET ST STE E
Second Line :
City : SEATTLE
State : WA
Zip : 98107-5815
Country : US
Telephone Number : 206-508-1265
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2011
Last Update Date : 04/05/2011

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Directions to “ MS. TIFFANY KUESPERT ” Practice Location

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