Provider Demographics
NPI:1790904613
Name:GROSSHANS, TERRI LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNN
Last Name:GROSSHANS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:LYNN
Other - Last Name:HAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 MADISON ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:
Practice Address - Street 1:3909 9TH AVE SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5134
Practice Address - Country:US
Practice Address - Phone:360-570-3460
Practice Address - Fax:360-339-7266
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA14739225700000X
WAPA60600225363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist