Provider Demographics
NPI:1558950550
Name:LORD, TAMMY A (RN)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:A
Last Name:LORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18309 NE 101ST CT
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3277
Mailing Address - Country:US
Mailing Address - Phone:425-591-5710
Mailing Address - Fax:
Practice Address - Street 1:17700 NE 76TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3300
Practice Address - Country:US
Practice Address - Phone:425-202-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00087637163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine