MEDICARE: TIFFANY MARIE BIEKER 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	172M00000X	Mechanotherapist	16850	OR

General Provider Information

NPI Number	:	1689905382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY MARIE BIEKER LMT

Provider Business Mailing Address
First Line	:	2008 WILLAMETTE FALLS DR
Second Line	:	STE 200
City	:	WEST LINN
State	:	OR
Zip	:	97068-4658
Country	:	US
Telephone Number	:	503-607-0018
Fax Number	:

Provider Business Practice Location Address
First Line	:	2008 WILLAMETTE FALLS DR
Second Line	:	STE 200
City	:	WEST LINN
State	:	OR
Zip	:	97068-4658
Country	:	US
Telephone Number	:	503-607-0018
Fax Number	:

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

Provider Enumeration Date	:	01/19/2010
Last Update Date	:	12/26/2012

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