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Individual
RENEE T TEDDER
Active
Individual
RENEE T TEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009010
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0219728
DEPT. OF LABOR & INDUSTRY
WA
01
—
1192TE
REGENCE BLUE SHIELD
WA
01
—
4939TE
REGENCE BLUE SHIELD
WA
01
—
5691TE
REGENCE BLUE SHIELD
WA
01
—
6544TE
REGENCE BLUE SHIELD
WA
01
—
710883456-98501-A010
TRICARE
WA
01
—
710883456-98502-A005
TRICARE
WA
01
—
710883456-98503-A009
TRICARE
WA
01
—
710883456-98512-A008
TRICARE
WA
01
—
710883456-98516-A003
TRICARE
WA
01
—
7242925
AETNA
WA
05
—
8401820
—
WA
01
—
8493TE
REGENCE BLUE SHIELD
WA
01
—
8944149
L&I CRIME VICTIMS
WA
Enumeration date
10/16/2006
Last updated
01/16/2009
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