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General NPI Number Information
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NPI Number | 1750401204
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Entity Type | Individual
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Provider Name | TERRIE M FORD MS ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 20 N TACOMA AVE
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City | TACOMA
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State | WA
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Zip | 98403-3133
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Country | US
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Telephone | 614-301-4399
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Fax |
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Provider Business Mailing Address
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Address Line | 117 N TACOMA AVE APT 805
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City | TACOMA
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State | WA
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Zip | 98403-2622
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Country | US
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Telephone | 614-301-4399
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP 60663882
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License Number State | WA
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