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NPI Code Detail

MEDICARE: CHRISTINE Y TERRY PHYSCIANS ASSISTANT

MEDICARE: CHRISTINE Y TERRY PHYSCIANS ASSISTANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA10005130WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA10005130OTHERWARAILROAD MEDICARE

General Provider Information

NPI Number : 1740341338
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE Y TERRY PHYSCIANS ASSISTANT
Provider Business Mailing Address
First Line : 21822 76TH AVE W
Second Line :
City : EDMONDS
State : WA
Zip : 98026-7900
Country : US
Telephone Number : 425-775-7166
Fax Number : 425-672-8844
Provider Business Practice Location Address
First Line : 21822 76TH AVE W
Second Line :
City : EDMONDS
State : WA
Zip : 98026-7900
Country : US
Telephone Number : 425-775-7166
Fax Number : 425-672-8844
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2006
Last Update Date : 06/08/2021

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Directions to “ CHRISTINE Y TERRY PHYSCIANS ASSISTANT” Practice Location

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