Provider Demographics
NPI:1437293909
Name:FORNO, CELIA G (PMHNP)
Entity type:Individual
Prefix:MS
First Name:CELIA
Middle Name:G
Last Name:FORNO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MS
Other - First Name:CELIA
Other - Middle Name:GRACE
Other - Last Name:FORNO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:711 STATE AVE NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-3984
Mailing Address - Country:US
Mailing Address - Phone:360-943-0780
Mailing Address - Fax:
Practice Address - Street 1:711 STATE AVE NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-3984
Practice Address - Country:US
Practice Address - Phone:360-943-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9398276363L00000X
OR200950152NP363LP0808X
AZAP2339363LP0808X
WAAP60164040363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner