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General NPI Number Information
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NPI Number | 1003138033
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Entity Type | Individual
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Provider Name | DEMETRIOS TEREZAKIS
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Gender | Male
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Dates
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Enumeration Date | 02/17/2010
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 325 9TH AVE
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City | SEATTLE
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State | WA
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Zip | 98104-2420
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Country | US
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Telephone | 206-744-6112
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Fax |
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Provider Business Mailing Address
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Address Line | 1833 13TH AVE APT 402
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City | SEATTLE
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State | WA
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Zip | 98122-2528
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 00003792
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License Number State | CA
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