Tiffany Jill Cottrell
Individual provider Active NPI Specialist · Snoqualmie, WA
NPI 1003962630 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003962630
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MA00018776 (WA)
- Practice address
- 7723 Center Blvd SE
Snoqualmie, WA 98065-8930 - Phone
- (425) 396-7778
- Fax
- (425) 396-7097
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00018776 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Snoqualmie Ridge Physical Therapy, P.S. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00018776 | WA | Yes |
Addresses
Primary practice location
7723 Center Blvd SE
Snoqualmie, WA 98065-8930
Mailing address
35127 SE Ridge St
Snoqualmie, WA 98065-9081
Phone (425) 396-7422
Other providers in Snoqualmie, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.