Provider Demographics
NPI:1629322284
Name:NESTER, THERESA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:ANN
Last Name:NESTER
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 1:921 TERRY AVENUE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1256
Mailing Address - Country:US
Mailing Address - Phone:206-292-2348
Mailing Address - Fax:206-292-4442
Practice Address - Street 1:921 TERRY AVENUE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1256
Practice Address - Country:US
Practice Address - Phone:206-292-2348
Practice Address - Fax:206-292-4442
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039984207ZB0001X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine