Basic Information
| Provider Information | |||||||||
| NPI: | 1497186746 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LANGANKE | ||||||||
| FirstName: | TIFFINY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32115 105TH PL SE APT B101 | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980924744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3602808441 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22659 PACIFIC HWY S | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | DES MOINES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981985155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068243668 | ||||||||
| FaxNumber: | 2068243964 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2013 | ||||||||
| LastUpdateDate: | 12/11/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | P1 60238163 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.