Healthcare Provider Details

I. General information

NPI: 1316017411
Provider Name (Legal Business Name): TERESA MARIE SCHLESINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21616 76TH AVE W SUITE #112
EDMONDS WA
98026-7512
US

IV. Provider business mailing address

PO BOX 2329
MOUNT VERNON WA
98273-7329
US

V. Phone/Fax

Practice location:
  • Phone: 425-775-6651
  • Fax: 425-670-6718
Mailing address:
  • Phone: 360-336-6517
  • Fax: 360-466-2682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD00028002
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: