Healthcare Provider Details

I. General information

NPI: 1316703630
Provider Name (Legal Business Name): TERESSA EYLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 S 102ND ST SUITE 220
TUKWILA WA
98168-1870
US

IV. Provider business mailing address

2811 S 102ND ST SUITE 220
TUKWILA WA
98168-1870
US

V. Phone/Fax

Practice location:
  • Phone: 425-525-6800
  • Fax:
Mailing address:
  • Phone: 425-525-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberNC10004084
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: