Angie Tietsort, LMP is a
Massage Therapist based in Republic, Washington. Angie Tietsort is licensed to practice in Washington (license number MA60613576) and her current practice location is
28 North Keller Street, Republic, Washington. She can be reached at her office (for appointments etc.) via phone at
(336) 250-8581.
NPI number for Angie Tietsort is 1952766503 and her current mailing address is 4466 Colt Way, Springdale, Washington. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1952766503.
Healthcare Provider's Profile
| Full Name | Angie Tietsort |
|---|
| Gender | Female |
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| Speciality | Massage Therapist |
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| Location | 28 North Keller Street, Republic, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1952766503
- Provider Enumeration Date: 12/28/2015
- Last Update Date: 12/28/2015
Medical Identifiers
Medical identifiers for Angie Tietsort such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1952766503 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225700000X | Massage Therapist | MA60613576 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Angie Tietsort is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Angie Tietsort, LMP
4466 Colt Way,
Springdale, WA 99173-5100
Ph: (336) 250-8581 | Angie Tietsort, LMP
28 North Keller Street,
Republic, WA 99166
Ph: (336) 250-8581 |
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