Provider Demographics
NPI:1326063546
Name:BELL, TERESA D (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:D
Last Name:BELL
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 1:2522 N PROCTOR ST # 42
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-5338
Mailing Address - Country:US
Mailing Address - Phone:253-759-5236
Mailing Address - Fax:
Practice Address - Street 1:3333 N WHITMAN ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-1547
Practice Address - Country:US
Practice Address - Phone:253-759-3065
Practice Address - Fax:253-759-3075
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00038458208600000X
IDM-136642086S0102X
ORMD2079272086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAF82194Medicare UPIN