Healthcare Provider Details

I. General information

NPI: 1538147764
Provider Name (Legal Business Name): FORREST G MCGRIFF ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 10/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 14TH AVE
LONGVIEW WA
98632-2315
US

IV. Provider business mailing address

14731 AURORA AVE N
SHORELINE WA
98133-6547
US

V. Phone/Fax

Practice location:
  • Phone: 360-703-7400
  • Fax: 360-353-3611
Mailing address:
  • Phone: 206-365-0220
  • Fax: 206-365-6436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30003894
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: