Basic Information
Provider Information
NPI: 1164971610
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TURRO
FirstName: DAVID
MiddleName: C
NamePrefix:  
NameSuffix: JR.
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2525 NE 139TH ST
Address2: SUITE 140
City: VANCOUVER
State: WA
PostalCode: 986862719
CountryCode: US
TelephoneNumber: 3608822778
FaxNumber:  
Practice Location
Address1: 700 NE 87TH AVE
Address2: SUITE 140
City: VANCOUVER
State: WA
PostalCode: 986641913
CountryCode: US
TelephoneNumber: 3603973352
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/26/2016
LastUpdateDate: 09/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMD60696527WAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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