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General NPI Number Information
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NPI Number | 1033277694
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Entity Type | Organization
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Legal Business Name | MT RAINIER SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 419 S L ST STE 101
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City | TACOMA
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State | WA
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Zip | 98405-3799
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Country | US
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Telephone | 253-383-5949
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Fax | 253-383-5953
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Provider Business Mailing Address
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Address Line | 419 S L ST STE 101
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City | TACOMA
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State | WA
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Zip | 98405-3799
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Country | US
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Telephone | 253-383-5949
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Fax | 253-383-5953
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. THERESA M TEREM
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Credential | M.D.
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Telephone | 253-383-5949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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