Provider Demographics
NPI:1083779433
Name:ANDERSON, TERESA JANE (BS)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:JANE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:JANE
Other - Last Name:HANCHETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS
Mailing Address - Street 1:9509 48TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2623
Mailing Address - Country:US
Mailing Address - Phone:206-718-8649
Mailing Address - Fax:206-686-7300
Practice Address - Street 1:26 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:WA
Practice Address - Zip Code:98541-9433
Practice Address - Country:US
Practice Address - Phone:206-656-7300
Practice Address - Fax:206-686-7300
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist