Provider Demographics
NPI:1033754296
Name:DURAN, TERRY (APRN)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:
Last Name:DURAN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15515 JUANITA WOODINVILLE WAY NE UNIT N301
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-6111
Mailing Address - Country:US
Mailing Address - Phone:425-298-5278
Mailing Address - Fax:
Practice Address - Street 1:15515 JUANITA WOODINVILLE WAY NE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-1576
Practice Address - Country:US
Practice Address - Phone:425-298-5278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61376797363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily