Provider Demographics
NPI:1174527782
Name:HUSSEINI, TINA MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:TINA
Middle Name:MARIA
Last Name:HUSSEINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1610 BISHOP RD. SW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512
Mailing Address - Country:US
Mailing Address - Phone:360-754-3338
Mailing Address - Fax:360-753-4861
Practice Address - Street 1:1610 BISHOP RD. SW
Practice Address - Street 2:SUITE 101
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512
Practice Address - Country:US
Practice Address - Phone:360-754-3338
Practice Address - Fax:360-753-4861
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2015-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00036499207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8237422Medicaid
WAGAB27156Medicare UPIN
WA8237422Medicaid
WA8804765Medicare PIN