MEDICARE: TIANA M. DUNCAN LMT

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
1	225700000X	Massage Therapist	000243329	WA

General Provider Information

NPI Number	:	1639786379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIANA M. DUNCAN LMT

Provider Business Mailing Address
First Line	:	5122 S FINDLAY ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-2559
Country	:	US
Telephone Number	:	206-240-8497
Fax Number	:

Provider Business Practice Location Address
First Line	:	3250 AIRPORT WAY S STE 322
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98134-2167
Country	:	US
Telephone Number	:	206-240-8497
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2020
Last Update Date	:	09/27/2020

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