Healthcare Provider Details

I. General information

NPI: 1376897470
Provider Name (Legal Business Name): TERESA HULL OWENS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2012
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 NW 80TH ST # 178
SEATTLE WA
98117-4449
US

IV. Provider business mailing address

2400 NW 80TH ST # 178
SEATTLE WA
98117-4449
US

V. Phone/Fax

Practice location:
  • Phone: 206-605-0462
  • Fax:
Mailing address:
  • Phone: 206-605-0462
  • Fax: 206-603-0764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60315348
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60315348
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: