Provider Demographics
NPI:1548641756
Name:ARTIME, TIFFANY (PHD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:ARTIME
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 65TH AVE W
Mailing Address - Street 2:
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-6200
Mailing Address - Country:US
Mailing Address - Phone:253-566-5559
Mailing Address - Fax:253-565-0274
Practice Address - Street 1:2002 65TH AVE W
Practice Address - Street 2:
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-6200
Practice Address - Country:US
Practice Address - Phone:253-566-5559
Practice Address - Fax:253-565-0274
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 60461645103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist