NPI 1578763967

Annie Elizabeth Tiedeman, LMP

Practitioner Specialist Leavenworth, WA

Practice location

Address: 11779 Highway 2 Suite 104, Leavenworth, WA 98826-1362
Phone: (509) 548-6130
Mailing address: 10802 Eagle Creek Rd, Leavenworth, WA 98826-9116

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence MA00024507 (WA)

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Registry record

NPI: 1578763967
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Jul 2007
Record last updated: 23 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.