Healthcare Provider Details

I. General information

NPI: 1588220735
Provider Name (Legal Business Name): TIERNEY S MCQUAID CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N NORTHGATE WAY
SEATTLE WA
98133-8916
US

IV. Provider business mailing address

1200 N NORTHGATE WAY
SEATTLE WA
98133-8916
US

V. Phone/Fax

Practice location:
  • Phone: 800-769-0045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP60903429
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60879160
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: