Provider Demographics
NPI:1376984286
Name:ARNESON, THERESA KAE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:KAE
Last Name:ARNESON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9722 HUNTER POINT RD NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-9708
Mailing Address - Country:US
Mailing Address - Phone:360-866-0698
Mailing Address - Fax:
Practice Address - Street 1:601 MCPHEE RD SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5080
Practice Address - Country:US
Practice Address - Phone:360-956-2543
Practice Address - Fax:360-956-2545
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00022073174400000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No174400000XOther Service ProvidersSpecialist