Provider Demographics
NPI:1508945890
Name:ROSSI, TERRI L (MS, GCFP, LMP, NCMMT)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:ROSSI
Suffix:
Gender:F
Credentials:MS, GCFP, LMP, NCMMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 UDDENBERG LN
Mailing Address - Street 2:STE 3
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-5128
Mailing Address - Country:US
Mailing Address - Phone:206-713-7169
Mailing Address - Fax:
Practice Address - Street 1:3220 UDDENBERG LN
Practice Address - Street 2:SUITE 3
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-5128
Practice Address - Country:US
Practice Address - Phone:206-713-7169
Practice Address - Fax:253-358-3057
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020265225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA285812OtherWA STATE L&I
WA261803189OtherGROUP HEALTH
WA618185700OtherFEDERAL L&I
WA285812OtherWA STATE L&I