Healthcare Provider Details

I. General information

NPI: 1124357694
Provider Name (Legal Business Name): CEDAR ELLIOT DURFEE MSN, ARNP, CNM, CLC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CE DURFEE ARNP, CLC, CD(DONA)

II. Dates (important events)

Enumeration Date: 12/13/2009
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 WESTGATE BLVD STE 274
TACOMA WA
98406-2571
US

IV. Provider business mailing address

6002 WESTGATE BLVD STE 274
TACOMA WA
98406-2571
US

V. Phone/Fax

Practice location:
  • Phone: 253-509-2960
  • Fax:
Mailing address:
  • Phone: 253-470-8047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61190774
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP61190774
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60971515
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: