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NPI Code Detail

MEDICARE: MRS. TIFFANY MICHELLE GREEN D.C.

MEDICARE: MRS. TIFFANY MICHELLE GREEN D.C.
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
1111N00000XChiropractorCH60070039WA
2111N00000XChiropractorDC-30447CA

General Provider Information

NPI Number : 1720262702
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY MICHELLE GREEN D.C.
Provider Business Mailing Address
First Line : 4236 36TH AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98118-1312
Country : US
Telephone Number : 206-723-2820
Fax Number :
Provider Business Practice Location Address
First Line : 4236 36TH AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98118-1312
Country : US
Telephone Number : 206-723-2820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2007
Last Update Date : 03/31/2009

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Directions to “ MRS. TIFFANY MICHELLE GREEN D.C.” Practice Location

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