Provider Demographics
NPI:1235159484
Name:RITTER, TERESA M (ARNP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:M
Last Name:RITTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:M
Other - Last Name:HARDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1717 S J ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4933
Mailing Address - Country:US
Mailing Address - Phone:253-426-6341
Mailing Address - Fax:253-377-1558
Practice Address - Street 1:1717 S J ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4933
Practice Address - Country:US
Practice Address - Phone:253-426-6341
Practice Address - Fax:253-377-1558
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334353363LF0000X
WAAP60113471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0263062OtherSTATE L&I
WA0278194OtherSTATE L&I
WA2003972Medicaid
WAAP60113471OtherWA LICENSE
WA0278192OtherSTATE L&I
WA0279451OtherSTATE L&I
WA0289349OtherL&I NWNEPH
WACD8128OtherRAILROAD MEDICARE GROUP #
WA0279448OtherSTATE L&I
WAG8900156Medicare PIN
WA0278194OtherSTATE L&I
WACD8128OtherRAILROAD MEDICARE GROUP #
RA4997Medicare PIN
WA0289349OtherL&I NWNEPH
WAG8891303Medicare PIN
WA0279451OtherSTATE L&I
WAG8887300Medicare PIN
WAG8900599Medicare PIN
WAG8851596Medicare PIN
WAG8851597Medicare PIN
WA0278192OtherSTATE L&I
Q30671Medicare UPIN
WAG8887301Medicare PIN
WAG8891304Medicare PIN