Provider Demographics
NPI:1194748913
Name:HESS, TERRENCE EUGENE (DPM)
Entity type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:EUGENE
Last Name:HESS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1610 BISHOP RD SW STE 101
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7303
Mailing Address - Country:US
Mailing Address - Phone:360-338-0004
Mailing Address - Fax:360-515-0744
Practice Address - Street 1:1610 BISHOP RD SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7303
Practice Address - Country:US
Practice Address - Phone:360-754-3338
Practice Address - Fax:360-753-4861
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO 00000517213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1093632Medicaid
WA7122997Medicaid
WA4529760002Medicare NSC
WAAB33649Medicare PIN
WAU55857Medicare UPIN
WAAB33650Medicare PIN
WA4529760001Medicare NSC