Active NPI
Tiffany Lynn Forquer, PA-C
- Physician Assistant
- Puyallup, WA
National Provider Identifier
1669747275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA60247690
- Practice address
- 413 29TH St NE Ste I
Puyallup, WA 98372-7154 - Phone
- (855) 255-1750
- Fax
- (855) 255-0905
- NPI assigned
- Mar 14, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA60247690 | WA | Primary |
Addresses
Primary practice location
413 29TH St NE Ste I
Puyallup, WA 98372-7154
Mailing address
413 29TH St NE Ste I
Puyallup, WA 98372-7154
Phone (855) 255-1750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2023039 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients | |
| United Wound Healing Accountable Care Consultants PLLC | Physician Assistant | Current | Accepting new patients |
| Multicare Health System | Current | Accepting new patients |
Locations
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
413 29th St NE
Ste I
Puyallup, WA 98372
2913 5th Ave NE
Ste 101
Puyallup, WA 98372
Phone (253) 905-0646
311 S L St
Tacoma, WA 98405
Phone (253) 403-1444
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Neurological Surgery Physician
- Tacoma, WA
- NPI 1497766638
-
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Puyallup, WA
- NPI 1669845327
-
- Pediatrics Physician
- Gig Harbor, WA
- NPI 1225674963
-
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
-
- Surgery Physician
- Puyallup, WA
- NPI 1881337632
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1669747275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 29TH ST NE STE I",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983727154",
"telephone_number": "855-255-1750",
"fax_number": "855-255-0905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 29TH ST NE STE I",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983727154",
"telephone_number": "855-255-1750",
"fax_number": "855-255-0905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORQUER",
"first_name": "TIFFANY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-14",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA60247690",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2023039",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.