Healthcare Provider Details

I. General information

NPI: 1710816343
Provider Name (Legal Business Name): TIFFANY CHRISTINE CHIANG PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 S 23RD ST STE 100
TACOMA WA
98405-1615
US

IV. Provider business mailing address

3315 S 23RD ST STE 100
TACOMA WA
98405-1615
US

V. Phone/Fax

Practice location:
  • Phone: 253-883-4140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.PA.70144605
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: