DR. TERRY ELIZABETH DOUGLASS


Address: 6863 Eagle Harbor Dr Ne, Bainbridge Island, WA 98110-3103
Phone: 2606606199

DR. TERRY ELIZABETH DOUGLASS (NPI# 1295728244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1295728244
Entity Type Individual
Full Name DR. TERRY ELIZABETH DOUGLASS
Other Name DR. THERESSE ELIZABETH DOUGLASS
Credential ARNP, PHD
Practice Address 6863 Eagle Harbor Dr Ne
Bainbridge Island
WA 98110-3103
Practice Telephone 2606606199
Practice Fax Number 2062389777
Mailing Telephone 2066606199
Mailing Fax Number 2062389777
Enumeration Date 2005-08-25
Last Update Date 2014-11-14
NPI Deactivation Date 03/25/2006
NPI Reactivation Date 2006-04-06
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163WP0807X Registered Nurse
Specialization: Psych/Mental Health, Child & Adolescent
AP30000194 WA Nursing Service Providers
Y 163WP0808X Registered Nurse
Specialization: Psych/Mental Health
AP30000194 WA Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
WA 9605122 05

Office Location

Street Address 6863 EAGLE HARBOR DR NE
City BAINBRIDGE ISLAND
State WA
Zip Code 98110-3103

Providers in the same location

NPI Name Taxonomy Address Enumeration
1356378921 Theresse Elizabeth Gibbs Douglass Nurse Practitioner 6863 Eagle Harbor Dr Ne, Bainbridge Island, WA 98110-3103 2006-06-27

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NPI Name Taxonomy Address Enumeration
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1326601055 Chloe Samantha Simon Specialist/Technologist 9650 Green Spot Pl., Req, Bainbridge Island, WA 98110 2019-04-18
1043721228 Laura West Baker Counselor 11073 Madison Ave. N.e., Bainbridge Island, WA 98110 2017-10-16
1609305978 Autism Coaching, Consulting, and Training, LLC Early Intervention Provider Agency 676 Lovell Ave Nw, Bainbridge Island, WA 98110 2017-06-08
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1578813929 Kitsap County Fire District No 2 Ambulance 8895 Madison Ave Ne, Bainbridge Island, WA 98110 2012-09-13
1841582707 David Warren Sugarman Psychologist 4080 Crystal Springs Dr Ne, Bainbridge Island, WA 98110 2011-05-11
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Taxonomy Information

Taxonomy Code 163WP0808X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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1609351717 Charlotte Gex Morgan Registered Nurse 57 W Main St Ste 260, Chehalis, WA 98532-4815 2018-09-25
1821571050 Kimberlee Susan Long Registered Nurse 4104 Puffin Rd, Ferndale, WA 98248-9579 2018-09-13
1235669607 Bridget Lash Registered Nurse 4319 Tyler Way, Anacortes, WA 98221-3215 2017-06-18
1174072623 Vicki Boothe Registered Nurse 26254 Ne Barrett Rd, Kingston, WA 98346-9342 2016-09-26
1265981997 Lorraine Jeanette Diricco Registered Nurse 1717 W Francis Ave Ste 204, Spokane, WA 99205 2016-09-22
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Competitor

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City BAINBRIDGE ISLAND
Zip Code 98110

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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