Provider Demographics
NPI:1710700950
Name:EMINENCE CAREMED
Entity type:Organization
Organization Name:EMINENCE CAREMED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFENY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:MA-P
Authorized Official - Phone:253-216-2191
Mailing Address - Street 1:2715 SW 331ST ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2833
Mailing Address - Country:US
Mailing Address - Phone:253-431-3273
Mailing Address - Fax:
Practice Address - Street 1:522 W RIVERSIDE AVE STE N
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0581
Practice Address - Country:US
Practice Address - Phone:253-216-2191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty