Provider Demographics
NPI:1831668409
Name:PIERCE, DOROTHY J
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:J
Last Name:PIERCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 20TH ST E STE C
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-1830
Mailing Address - Country:US
Mailing Address - Phone:253-235-5216
Mailing Address - Fax:253-235-5216
Practice Address - Street 1:800 S MERIDIAN STE A&B
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-6995
Practice Address - Country:US
Practice Address - Phone:253-235-5216
Practice Address - Fax:253-235-5216
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175T00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No175T00000XOther Service ProvidersPeer Specialist