Provider Demographics
NPI:1295925766
Name:APPLEGATE, TERI (LAC)
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17724
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98127-1300
Mailing Address - Country:US
Mailing Address - Phone:206-778-9907
Mailing Address - Fax:206-784-0228
Practice Address - Street 1:8122 GREEN LAKE DR N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-4412
Practice Address - Country:US
Practice Address - Phone:206-778-9907
Practice Address - Fax:206-784-0228
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002610171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist