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Individual
TERESA E VASICEK
Active
Individual
TERESA E VASICEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60535275
WA
363AM0700X
Medical Physician Assistant
PA60535275
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2042600
—
WA
Enumeration date
09/08/2014
Last updated
02/24/2022
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