Provider Demographics
NPI:1891346649
Name:FORSYTH, DAVID ANDREW (RN 60468173)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANDREW
Last Name:FORSYTH
Suffix:
Gender:M
Credentials:RN 60468173
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:518 SE MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:99324-1736
Mailing Address - Country:US
Mailing Address - Phone:509-529-1544
Mailing Address - Fax:
Practice Address - Street 1:55 W TIETAN ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4445
Practice Address - Country:US
Practice Address - Phone:509-525-3720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60468173163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse