Provider Demographics
NPI:1457661639
Name:FLORIA, TONYA NICOLE (LM, CPM)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:NICOLE
Last Name:FLORIA
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:
Other - Last Name:IVERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LM, CPM
Mailing Address - Street 1:13128 TOTEM LAKE BLVD NE SUITE 101
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-823-1919
Mailing Address - Fax:425-823-7037
Practice Address - Street 1:13128 TOTEM LAKE BLVD NE SUITE 101
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-823-1919
Practice Address - Fax:425-823-7037
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW60167345176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife