Provider Demographics
NPI:1508323221
Name:OWEN, TERI LEE (CPC)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:LEE
Last Name:OWEN
Suffix:
Gender:F
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 COMMERCE AVE STE H
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3732
Mailing Address - Country:US
Mailing Address - Phone:360-878-4610
Mailing Address - Fax:
Practice Address - Street 1:1338 COMMERCE AVE STE H
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3732
Practice Address - Country:US
Practice Address - Phone:360-878-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist