1235159484 NPI number — TERESA M. RITTER ARNP

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235159484 NPI number — TERESA M. RITTER ARNP

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

RITTER

Provider First Name:

TERESA

Provider Middle Name:

M.

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

ARNP

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

HARDING

Provider Other First Name:

TERESA

Provider Other Middle Name:

M

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

ARNP

Provider Other Last Name Type Code:

1

NPI Number:

1235159484

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/20/2025

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

634 S MACARTHUR ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

TACOMA

Provider Business Mailing Address State Name:

WA

Provider Business Mailing Address Postal Code:

98465-1820

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

253-355-9354

Provider Business Mailing Address Fax Number:

253-377-1558

Provider First Line Business Practice Location Address:

1717 S J ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

TACOMA

Provider Business Practice Location Address State Name:

WA

Provider Business Practice Location Address Postal Code:

98405-4933

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

253-426-6341

Provider Business Practice Location Address Fax Number:

253-377-1558

Provider Enumeration Date:

07/20/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 363LP0808X , with the licence number:  AP60113471 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 363LF0000X , with the licence number: AP60113471 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 363LF0000X , with the licence number: F334353 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 0278194 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 2003972 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
• Identifier: 0263062 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0289349 . This is a "L&I NWNEPH" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: AP60113471 . This is a "WA LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0278192 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0279451 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: CD8128 . This is a "RAILROAD MEDICARE GROUP #" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0279448 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".