Healthcare Provider Details
I. General information
NPI: 1831007376
Provider Name (Legal Business Name): TIERRA ASHCROFT TIERRA ASHCROFT
Entity Type: Individual
Gender:
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20302 190TH AVE E
ORTING WA
98360-9352
US
IV. Provider business mailing address
20302 190TH AVE E
ORTING WA
98360-9352
US
V. Phone/Fax
- Phone: 509-761-9272
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | 60815243 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: