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General NPI Number Information
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NPI Number | 1437293909
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Entity Type | Individual
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Provider Name | CELIA G FORNO PMHNP
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Gender | Female
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Dates
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Enumeration Date | 02/17/2007
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 711 STATE AVE NE
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City | OLYMPIA
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State | WA
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Zip | 98506-3984
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Country | US
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Telephone | 360-943-0780
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Fax |
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Provider Business Mailing Address
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Address Line | 711 STATE AVE NE
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City | OLYMPIA
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State | WA
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Zip | 98506-3984
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Country | US
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Telephone | 360-943-0780
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN9398276
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 200950152NP
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP2339
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP60164040
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License Number State | WA
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