MEDICARE: THERESA L FROELICH DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	OP00001283	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8934254	OTHER	WA	CRIME VICTIMS
3	176262	OTHER	WA	L & I
4	160059867	OTHER	WA	RAILROAD
5	8931181	OTHER	WA	CRIME VICTIMS
6	167394	OTHER	WA	L & I

General Provider Information

NPI Number	:	1306882915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA L FROELICH DO

Provider Business Mailing Address
First Line	:	7210 40TH ST W
Second Line	:	STE 100
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98466-4318
Country	:	US
Telephone Number	:	253-564-0170
Fax Number	:

Provider Business Practice Location Address
First Line	:	7210 40TH ST W
Second Line	:	STE 100
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98466-4318
Country	:	US
Telephone Number	:	253-564-0170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	11/16/2010

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Directions to “ THERESA L FROELICH DO” Practice Location

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