Provider Demographics
NPI:1619780400
Name:TERRE, ROBERT C
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:TERRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25327 32ND PL S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5600
Mailing Address - Country:US
Mailing Address - Phone:253-941-1292
Mailing Address - Fax:253-941-1292
Practice Address - Street 1:25327 32ND PL S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5600
Practice Address - Country:US
Practice Address - Phone:253-941-1292
Practice Address - Fax:253-941-1292
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA754899374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide