Provider Demographics
NPI:1316977317
Name:TORRES, JOANNE MARIE (MD)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:MARIE
Last Name:TORRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7424 108TH ST NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-6864
Mailing Address - Country:US
Mailing Address - Phone:734-975-1891
Mailing Address - Fax:
Practice Address - Street 1:2520 CHERRY AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-4229
Practice Address - Country:US
Practice Address - Phone:360-377-3911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078537207P00000X
WAMD00048174207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0103810872OtherBCBSM/WA FOOTE MEMORIAL
MI4785739Medicaid
MI104770772Medicaid
WA8486516Medicaid
MIP00247222OtherRR MEDICARE
WA8867020Medicare PIN
MI0103810872OtherBCBSM/WA FOOTE MEMORIAL
MII41587Medicare UPIN
MI4785739Medicaid
MIM88560038Medicare ID - Type UnspecifiedWA FOOTE MEMORIAL