Provider Demographics
NPI:1770178725
Name:TERRANOVA, DENA MARIE (DC)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:MARIE
Last Name:TERRANOVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DENA
Other - Middle Name:
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:601 S PINE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2795
Mailing Address - Country:US
Mailing Address - Phone:253-396-1000
Mailing Address - Fax:253-396-1012
Practice Address - Street 1:601 S PINE ST STE 201
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2795
Practice Address - Country:US
Practice Address - Phone:253-396-1000
Practice Address - Fax:253-396-1012
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002985111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor