Provider Demographics
NPI:1932341617
Name:GREENE, TESSA SHERI (DC)
Entity Type:Individual
Prefix:DR
First Name:TESSA
Middle Name:SHERI
Last Name:GREENE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8650 MARTIN WAY E STE 207
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-6610
Mailing Address - Country:US
Mailing Address - Phone:360-951-4504
Mailing Address - Fax:877-848-7757
Practice Address - Street 1:8650 MARTIN WAY E STE 207
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-6610
Practice Address - Country:US
Practice Address - Phone:360-951-4504
Practice Address - Fax:877-848-7757
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO008434111N00000X
WACHIRO008434111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor