Individual
MS. SANDRA E TETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT, CHT
Contact information
Practice address
9411 192ND AVE E BLDG D, SUITE E, BONNEY LAKE, WA 98391-8564
(253) 268-5105
(253) 258-3298
Mailing address
4220 132ND ST SE, SUITE 101, MILL CREEK, WA 98012-8999
(425) 357-9380
(425) 357-9382
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00001042
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185877
L&I
WA
01
—
6162TE
REGENCE BS
WA
05
—
8376683
—
WA
01
—
8938039
CRIME VICTIMS
WA
01
—
P00403555
MEDICARE RAILROAD
WA
Enumeration date
08/18/2005
Last updated
01/30/2017
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