MRS. Annie Elizabeth Tiedeman, LMP

NPI #1578763967 in Leavenworth, Washington

Provider Information

NPI Number: 1578763967
Entity Type: Individual
Name: MRS. Annie Elizabeth Tiedeman, LMP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: LMP
Enumeration Date: Jul 23, 2007
Last Updated: Jul 23, 2007

Practice Location

Address: 11779 HIGHWAY 2
Address 2: SUITE 104
City: Leavenworth
State: Washington
ZIP Code: 98826-1362
Phone: (509) 548-6130

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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