Healthcare Provider Details

I. General information

NPI: 1033506407
Provider Name (Legal Business Name): JUSTIN TEERLINCK MOT/R/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9399 RIDGETOP BLVD NW STE 101
SILVERDALE WA
98383-8580
US

IV. Provider business mailing address

4100 FOSTER STREET # 103
GIG HARBOR WA
98335
US

V. Phone/Fax

Practice location:
  • Phone: 360-516-1210
  • Fax:
Mailing address:
  • Phone: 503-422-5844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number334721
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: