Provider Demographics
NPI:1568692796
Name:TOLAN, TERESA LOUISE (RN, LMP, LMHC)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:LOUISE
Last Name:TOLAN
Suffix:
Gender:F
Credentials:RN, LMP, LMHC
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Mailing Address - Street 1:1001 COOPER POINT RD SW STE 140
Mailing Address - Street 2:PMB #316
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-1174
Mailing Address - Country:US
Mailing Address - Phone:360-943-8116
Mailing Address - Fax:360-753-1232
Practice Address - Street 1:549 MCPHEE RD SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5015
Practice Address - Country:US
Practice Address - Phone:360-943-8116
Practice Address - Fax:360-753-1232
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WALH60014833101YM0800X
WARN00048632163W00000X
WAMA00007338225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist