MEDICARE: THERESA M GIESELER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	SLPA.SP.70136974	WA

General Provider Information

NPI Number	:	1134054067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA M GIESELER

Provider Business Mailing Address
First Line	:	19921 145TH ST E
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-6180
Country	:	US
Telephone Number	:	858-880-6053
Fax Number	:

Provider Business Practice Location Address
First Line	:	19921 145TH ST E
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-6180
Country	:	US
Telephone Number	:	858-880-6053
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2026
Last Update Date	:	06/13/2026

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Directions to “ THERESA M GIESELER ” Practice Location

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