Provider Demographics
NPI:1982736971
Name:MCINERNEY, TERRY ANN (LMP)
Entity Type:Individual
Prefix:MISS
First Name:TERRY
Middle Name:ANN
Last Name:MCINERNEY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MISS
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:MAC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:7819 3RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4006
Mailing Address - Country:US
Mailing Address - Phone:206-713-0742
Mailing Address - Fax:
Practice Address - Street 1:1421 NW 70TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-5340
Practice Address - Country:US
Practice Address - Phone:206-713-0742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016276174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist