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1225725237 NPI number — TIFFANI JORDAN LUETT LAUTENSLAGER MD

NPI Number: 1225725237
Health Care Provider/Practitioner: TIFFANI JORDAN LUETT LAUTENSLAGER MD

Information about “1225725237” NPI (TIFFANI JORDAN LUETT LAUTENSLAGER MD) exists in 1225725237 in HTML format HTML  |  1225725237 in plain Text format TXT  |  1225725237 in PDF (Portable Document Format) PDF  |  1225725237 in an XML format XML  formats.

NPI Number : 1225725237 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225725237",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LUETT LAUTENSLAGER",
    "FirstName": "TIFFANI",
    "MiddleName": "JORDAN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LUETT",
    "OtherFirstName": "TIFFANI",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "501 S 5TH AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "YAKIMA",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98902-3550",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "509-853-1082",
    "MailingAddressFaxNumber": "509-573-6275",
    "FirstLinePracticeLocationAddress": "521 E MOUNTAIN VIEW AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ELLENSBURG",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98926-3865",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "509-962-1414",
    "PracticeLocationAddressFaxNumber": "509-452-5224",
    "EnumerationDate": "04/19/2023",
    "LastUpdateDate": "10/07/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": "ML61428976",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "ML61428976",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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