Healthcare Provider Details
I. General information
NPI: 1518125343
Provider Name (Legal Business Name): TIFFANY TAUSALA COLEMAN-SATTERFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/29/2008
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4800 SAND POINT WAY NE MAIL STOP MB 7.520
SEATTLE WA
98105
US
IV. Provider business mailing address
4800 SAND POINT WAY NE MAIL STOP MB 7.520
SEATTLE WA
98105
US
V. Phone/Fax
- Phone: 206-987-2599
- Fax: 206-729-3070
- Phone: 206-987-2599
- Fax: 206-729-3070
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD60222843 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: