Individual
TERRY J PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
211 SKYLINE DRIVE, WHITE SALMON, WA 98672-0099
(509) 493-1101
(509) 493-2838
Mailing address
211 SKYLINE DRIVE, PO BOX 99, WHITE SALMON, WA 98672-0099
(509) 493-1101
(509) 493-2838
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30003409
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP30003409
ARNP LICENSE NUMBER
WA
01
—
RN00117129
STATE LICENSE NUMBER
WA
Enumeration date
08/02/2006
Last updated
07/08/2007
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