Provider Demographics
NPI:1316017411
Name:SCHLESINGER, TERESA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:MARIE
Last Name:SCHLESINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2329
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-7329
Mailing Address - Country:US
Mailing Address - Phone:360-336-6517
Mailing Address - Fax:360-466-2682
Practice Address - Street 1:21616 76TH AVE W
Practice Address - Street 2:SUITE #112
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7512
Practice Address - Country:US
Practice Address - Phone:425-775-6651
Practice Address - Fax:425-670-6718
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028002207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1102649Medicaid
WASC8085OtherREGENCE BLUE SHIELD
WA0057003OtherDEPARTMENT OF LABOR AND INDUSTRIES
WA050055439OtherRAILROAD MEDICARE
WA1102649Medicaid
WA050055439OtherRAILROAD MEDICARE