Healthcare Provider Details
I. General information
NPI: 1730143280
Provider Name (Legal Business Name): TERESA M OGDEN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/13/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12410 E SINTO AVE STE B
SPOKANE VALLEY WA
99216-2280
US
IV. Provider business mailing address
PO BOX 3649
SPOKANE WA
99220-3649
US
V. Phone/Fax
- Phone: 509-838-2531
- Fax: 509-755-6580
- Phone: 509-838-2531
- Fax: 509-755-6580
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | AP30007293 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: