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General NPI Number Information
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NPI Number | 1770691586
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Entity Type | Individual
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Provider Name | TERESA LOUISE ARCHER OTA
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1830 112TH ST E SUITE D
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City | TACOMA
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State | WA
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Zip | 98445-3747
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Country | US
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Telephone | 253-548-8400
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Fax | 253-537-3150
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Provider Business Mailing Address
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Address Line | 8713 NEWGROVE AVE SW
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City | LAKEWOOD
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State | WA
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Zip | 98498-2549
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Country | US
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Telephone | 253-584-5027
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Fax | 253-537-3150
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OC00000168
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License Number State | WA
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