Provider Demographics
NPI:1538604855
Name:SIU, TIFFANY (PT, DPT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:SIU
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10330 MERIDIAN AVE N STE 110
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9484
Mailing Address - Country:US
Mailing Address - Phone:206-668-6032
Mailing Address - Fax:206-668-6035
Practice Address - Street 1:10330 MERIDIAN AVE N STE 110
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9484
Practice Address - Country:US
Practice Address - Phone:206-668-6032
Practice Address - Fax:206-668-6035
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60691151225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist