Provider Demographics
NPI:1033149927
Name:WASHINGTON, TORRI L (CNM)
Entity Type:Individual
Prefix:
First Name:TORRI
Middle Name:L
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 WHITE BEAR AVE N
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-5110
Mailing Address - Country:US
Mailing Address - Phone:651-600-3035
Mailing Address - Fax:651-348-8783
Practice Address - Street 1:15000 GARRETT AVE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-9018
Practice Address - Country:US
Practice Address - Phone:651-600-3035
Practice Address - Fax:651-348-8783
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1708408367A00000X
MN180367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN423600900Medicaid
Q60879Medicare UPIN