Provider Demographics
NPI:1861521445
Name:JENNIFER TANIGUCHI MD PS
Entity type:Organization
Organization Name:JENNIFER TANIGUCHI MD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KYMBERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHODRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-235-9981
Mailing Address - Street 1:17910 TALBOT RD S
Mailing Address - Street 2:100
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-6237
Mailing Address - Country:US
Mailing Address - Phone:425-235-9981
Mailing Address - Fax:425-271-1217
Practice Address - Street 1:17910 TALBOT RD S
Practice Address - Street 2:100
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6237
Practice Address - Country:US
Practice Address - Phone:425-235-9981
Practice Address - Fax:425-271-1217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty