Individual
MISS TERESE ANGELA DERZAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
2715 CALIFORNIA AVE SW, SEATTLE, WA 98116-2469
(206) 852-1555
Mailing address
PO BOX 16544, SEATTLE, WA 98116-0544
(206) 852-1555
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA14332
WA
Other
Enumeration date
02/10/2007
Last updated
07/08/2007
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