Provider Demographics
NPI:1437444999
Name:TERRY, GARTH EDWARD (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:GARTH
Middle Name:EDWARD
Last Name:TERRY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 S COLUMBIAN WAY
Mailing Address - Street 2:MS: S-116 MIRECC
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1532
Mailing Address - Country:US
Mailing Address - Phone:206-277-3871
Mailing Address - Fax:206-768-5364
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:MS: S-116 MIRECC
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108
Practice Address - Country:US
Practice Address - Phone:206-277-3871
Practice Address - Fax:206-768-5364
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD605805382084P0800X
CAA1238422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry