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General NPI Number Information
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NPI Number | 1356472120
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Entity Type | Individual
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Provider Name | TIFFANY I PAVESI PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 05/11/2010
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Provider Practice Location Address
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Address Line | 16824 HWY 99
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City | LYNNWOOD
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State | WA
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Zip | 98037-3167
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Country | US
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Telephone | 425-741-4302
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Fax | 425-741-4370
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Provider Business Mailing Address
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Address Line | 938 N 79TH ST
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City | SEATTLE
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State | WA
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Zip | 98103-4714
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Country | US
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Telephone | 360-421-8433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH00061264
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License Number State | WA
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