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General NPI Number Information
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NPI Number | 1710027503
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Entity Type | Individual
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Provider Name | TERESA DIANE HARBERG RPH
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 34509 9TH AVE S STE 308
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City | FEDERAL WAY
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State | WA
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Zip | 98003-8710
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Country | US
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Telephone | 253-944-6985
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Fax | 253-944-7585
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Provider Business Mailing Address
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Address Line | 35400 18TH AVE SW
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City | FEDERAL WAY
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State | WA
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Zip | 98023-6908
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Country | US
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Telephone | 253-235-5015
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH00015347
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License Number State | WA
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