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NPI Code Detail

MEDICARE: DANIEL MARTIN TIEVA M.D.

MEDICARE: DANIEL MARTIN TIEVA M.D.
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
1207Q00000XFamily Medicine Physician8150AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639464050
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL MARTIN TIEVA M.D.
Provider Business Mailing Address
First Line : 917 PACIFIC AVE STE 600
Second Line :
City : TACOMA
State : WA
Zip : 98402-4437
Country : US
Telephone Number : 253-844-4327
Fax Number :
Provider Business Practice Location Address
First Line : 821 N ST STE 102
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-3285
Country : US
Telephone Number : 253-844-4327
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2011
Last Update Date : 08/06/2025

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