Healthcare Provider Details

I. General information

NPI: 1376466516
Provider Name (Legal Business Name): SYDNEY FOX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

315 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4234
US

IV. Provider business mailing address

6236 PATIO ST SW
TUMWATER WA
98512-7233
US

V. Phone/Fax

Practice location:
  • Phone: 760-702-6581
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number70145991-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: