Provider Demographics
NPI:1043288491
Name:DANSCUK-SLOAN, THERESA A (WHNP)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:A
Last Name:DANSCUK-SLOAN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:MT
Mailing Address - Zip Code:59875
Mailing Address - Country:US
Mailing Address - Phone:360-621-0725
Mailing Address - Fax:360-475-4344
Practice Address - Street 1:ONE BOONE ROAD
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312
Practice Address - Country:US
Practice Address - Phone:360-475-4426
Practice Address - Fax:360-475-4344
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR094006381N7363LW0102X
OR363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health