MEDICARE: TERESA D FABRE LOPEZ

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	2255R0406X	Blind Rehabilitation Specialist/Technologist

General Provider Information

NPI Number	:	1447187109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA D FABRE LOPEZ

Provider Business Mailing Address
First Line	:	9600 VETERANS DR SW # A-117BRC
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98493-0003
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9600 VETERANS DR SW # A-117BRC
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98493-0003
Country	:	US
Telephone Number	:	253-583-1299
Fax Number	:

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

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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Directions to “ TERESA D FABRE LOPEZ ” Practice Location

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