Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 0119850 | WA |
NPI | 1003843525 |
---|---|
Provider Name | Mrs. Tiffany C Crabb |
First Address | Seattle, WA 98104-1172 |
Second Address | Lakewood, WA 98499-2777 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 18/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0215352 | LIWA (01) | WA |
2156SA | BSWA (01) | WA |
8468894 | (05) | WA |
SAN1980 | (02) | WA |