Provider Demographics
NPI:1982721858
Name:LAM, TERESA H (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:H
Last Name:LAM
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 1:5410 MARYLAND WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5339
Mailing Address - Country:US
Mailing Address - Phone:615-371-5763
Mailing Address - Fax:888-241-1404
Practice Address - Street 1:400 NE MOTHER JOSEPH PLACE
Practice Address - Street 2:COGENT INPATIENT SERVICES
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98668
Practice Address - Country:US
Practice Address - Phone:360-514-3727
Practice Address - Fax:360-514-3711
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML20008511390200000X
WAMD60026465207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0256029OtherWASHINGTON DOL
WAP00819272OtherRAILROAD MEDICARE WA
WA8558660Medicaid
WA8558660Medicaid