Provider Demographics
NPI:1467578591
Name:COURTNEY, TERRY S (LAC)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:S
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11750 2ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-4506
Mailing Address - Country:US
Mailing Address - Phone:206-783-1584
Mailing Address - Fax:425-602-3141
Practice Address - Street 1:14500 JUANITA DR NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-4966
Practice Address - Country:US
Practice Address - Phone:425-602-3120
Practice Address - Fax:425-602-3141
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000328171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist