Provider Demographics
NPI:1598648412
Name:TIFFANY, TREY TIMOTHY I
Entity type:Individual
Prefix:
First Name:TREY
Middle Name:TIMOTHY
Last Name:TIFFANY
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S CAMANO RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282-7528
Mailing Address - Country:US
Mailing Address - Phone:360-202-9222
Mailing Address - Fax:
Practice Address - Street 1:605 S CAMANO RIDGE RD
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-7528
Practice Address - Country:US
Practice Address - Phone:360-202-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician