Provider Demographics
NPI:1871030825
Name:WORK, TOD PIERSON (NP-C)
Entity Type:Individual
Prefix:MR
First Name:TOD
Middle Name:PIERSON
Last Name:WORK
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11306 BRIDGEPORT WAY SW STE D
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3037
Mailing Address - Country:US
Mailing Address - Phone:360-752-0518
Mailing Address - Fax:
Practice Address - Street 1:22014 7TH AVE S STE 105B
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6235
Practice Address - Country:US
Practice Address - Phone:253-347-6099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60726755363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP11102OtherADVANCED NURSE PRACTITIONER LICENSE
WAAP60726755OtherADVANCED NURSE PRACTITIONER LICENSE