Healthcare Provider Details

I. General information

NPI: 1336896083
Provider Name (Legal Business Name): EMILY PIERCE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 NORTH LOOP ROAD BLDG 390
FORT IRWIN CA
92310
US

IV. Provider business mailing address

9040 JACKSON AVE
TACOMA WA
98431-0001
US

V. Phone/Fax

Practice location:
  • Phone: 866-957-9224
  • Fax:
Mailing address:
  • Phone: 253-968-3774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101280538
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: