Provider Demographics
NPI:1902511132
Name:DULEY, TIFFANIE MARIE (RHIT)
Entity Type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:MARIE
Last Name:DULEY
Suffix:
Gender:F
Credentials:RHIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 NE 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-1511
Mailing Address - Country:US
Mailing Address - Phone:360-975-8974
Mailing Address - Fax:
Practice Address - Street 1:115 NE 14TH AVE
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-1511
Practice Address - Country:US
Practice Address - Phone:360-975-8974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604987848261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center